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乌司他丁对食管癌根治术中单肺通气肺损伤的保护作用
引用本文:王彬荣,田丽颖,王艳,张莲花,王高翔,孙绪德. 乌司他丁对食管癌根治术中单肺通气肺损伤的保护作用[J]. 陕西肿瘤医学, 2014, 0(2): 441-444
作者姓名:王彬荣  田丽颖  王艳  张莲花  王高翔  孙绪德
作者单位:[1]第四军医大学第二附属医院麻醉科,陕西西安710038 [2]陕西省人民医院麻醉科,陕西西安710068
基金项目:国家自然科学基金(编号:30972833)
摘    要:目的:探讨乌司他丁对食管癌根治术中单肺通气(OLV)肺损伤的保护作用。方法:全麻OLV下食管癌根治术患者60例,随机分为5组(n=12):对照组(R组),乌司他丁30万单位处理组(U1组),乌司他丁60万单位处理组(U2组),30万单位/4h乌司他丁持续泵入处理组(U3组),60万单位/4h乌司他丁持续泵入处理组(U4组)。单肺通气后注入等容量生理盐水、单次或者持续泵入乌司他丁。各组于单肺通气后、给药前(T0)、给药后1小时(T1)、2小时(T2)、4小时(T3)及术后1天(T4) 抽取静脉血5ml,测定血浆中髓过氧化物酶(MPO)、肿瘤坏死因子α(TNF-α)和丙二醛(MDA)的含量。结果:在T1时间点,与R组比较,U1、U2、U3、U4组MPO、MDA、TNF-α含量下降(P<0.05),U2组较U1、U3、U4组下降更明显(P<0.05);在T2、T3时间点, U2、U3、U4组较U1、R组MPO、MDA、TNF-α含量下降明显(P<0.05),其中以U4组上述指标下降最显著,差异具有统计学差异(P<0.05);T4时间点各组间无明显差异(P>0.05)。结论:乌司他丁能显著降低食管癌根治术单肺通气患者血清MPO、MDA和TNF-α含量,在食管癌根治术OLV中发挥肺保护作用。

关 键 词:乌司他丁  单肺通气  肺损伤  肺保护  髓过氧化物酶  肿瘤坏死因子α  丙二醛

The protective effect of Ulinastatin on the pulmonary injury in radical surgery for esophageal cancer
Wang Binrong; Tian Liying; Wang Yan; Zhang Lianhua; Wang Gaoxiang; Sun Xude. The protective effect of Ulinastatin on the pulmonary injury in radical surgery for esophageal cancer[J]. Shaanxi Oncology Medicine, 2014, 0(2): 441-444
Authors:Wang Binrong   Tian Liying   Wang Yan   Zhang Lianhua   Wang Gaoxiang   Sun Xude
Affiliation:Wang Binrong; Tian Liying; Wang Yan; Zhang Lianhua; Wang Gaoxiang; Sun Xude(1.Department of Anesthesiology,Tangdu Hospital,Fourth Military Medical University,Shaanxi Xi'an 710038, China;2.Department of Anesthesiology,Shaanxi Province People's Hospital,Shaanxi Xi'an 710068,China.)
Abstract:Objective:To explore the lung protective effect of ulinastatin on esophageal cancer resection during one-lung ventilation.Methods:Sixty esophageal cancer resection patients were divided into five groups randomly.Control group R (n=12):the same volume of nomal saline as in other group in stead of ulinastatin.U1 group:ulinastatin 300000U intravenous infusion.U2 group:ulinastatin 600000U intravenous infusion.U3 group:ulinastatin 300000U intravenous infusion continually in four hours.U4 group:ulinastatin 600000U intravenous infusion continually in four hours.Blood concentrations of myeloperoxidase (MPO),tumor necrosis factor (TNF)-α and malondialdehyde (MDA) were tested after one-lung ventilation and before dosage (T0);one hour after one-lung ventilation (T1);two hours after one-lung ventilation(T2);four hours after one-lung ventilation(T3) and 1 day after operation (T4).Results:At the time point of T1,compared with R group,there was decrease in MPO,MDA and TNF-α in other group (P〈0.05).At T2 and T3,compared with R,U1 group,there was decrease in MPO,MDA and TNF-α in U2,U3 and U4 group,especially in U4 group (P〈0.05).At T4,there was no differences in every group (P〉0.05).Conclusion:Ulinastatin significantly decreased in patients with esophageal cancer resection OLV serum MPO,MDA and TNF-α,and play a protective role on the pulmonary injury in radical surgery for esophageal cancer during OLV.
Keywords:Ulinastatin  one-lung ventilation  pulmonary injury  lung protection effect  myeloproxidase  malondialdehyde  tumor necrosis factor-α
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