依达拉奉对胸腔镜手术中单肺通气氧化应激反应及炎性反应的影响

目的观察依达拉奉对胸腔镜手术中单肺通气肺损伤的影响。方法选择择期行胸腔镜肺叶切除手术的肺癌患者40例,均为男性,年龄47~65岁,身高165~183cm,体重64~85kg,BMI30kg/m2,ASAⅠ或Ⅱ级。随机将患者分为两组:对照组(C组)和依达拉奉组(E组),每组20例。E组于手术前30min开始静脉输注依达拉奉30mg(溶于100ml生理盐水),30min内输注完毕;C组以等量生理盐水同速滴注。记录手术时间、术中单肺通气时间;记录开胸前(T1)、开胸后单肺通气开始时(T2)、单肺通气30min(T3)、单肺通气60min(T4)、单肺通气结束(T5)、术毕(T6)时的PETCO2和气道压峰值(Pmax)。两组分别于T1和T6时取肘静脉血样5 ml,检测血清IL-8、IL-10、TNF-α和血清肺表面活性蛋白A(SP-A)的水平。结果两组各时点PETCO2、Pmax差异无统计学意义。与T1时比较,T6时两组血清IL-8、IL-10、TNF-α、SP-A浓度明显升高(P0.05);T6时E组IL-8、TNF-α、SP-A浓度明显低于C组(P0.05),两组IL-10浓度差异无统计学意义。结论依达拉奉预先给药可抑制单肺通气时氧化应激反应及炎性反应。

Effect of edaravone pretreatment on oxidative stress and inflammatory reaction during one lung ventilation of patients underwent thoracoscopic surgery

Objective To observe the effect of edaravone pretreatment on the lung injury during one lung ventilation of patients undergoing thoracoscopic surgery.Methods Forty male patients diagnosed of lung cancer (aged 47-65 years,height 165-183 cm,weight 64-85 kg,BMI<30 kg/m2 ,ASA gradeⅠorⅡ)who were scheduled for thoracoscopic pulmonary resection surgery were randomly divided into two groups(n =20 each):control group (group C)and edaravone group (group E).In group E edaravone 30mg(dissolution in normal saline 100 ml)was administered within 30 min before surgery.In group C nor-mal saline 100 ml was administered within the same time.PET CO2 and peak airway pressure (Pmax)were recorded during operation,venous blood samples were taken before skin incision and at the end of operation for detection of the concentration of IL-8,IL-10,TNF-α and SP-A.Results There were no significant difference in PET CO2 and Pmax between the two groups..Compared with T1 ,concentration of IL-8,IL-10, TNF-αand SP-A all increased significantly in both groups on T6 (P <0.05).Compared with group C,IL-8, TNF-αand SP-A levels of T6 in group E were lower significantly (P < 0.05 ).There was no significant differences in the levels of IL-10 between the two groups.Conclusion Edaravone can inhibit oxidative stress and inflammatory reaction during one lung ventilation in patients underwent thoracoscopic surgery.