单肺通气方式对围术期炎性细胞因子的影响

目的观察单肺通气（OLV）方式对患者围术期炎性细胞因子影响。方法拟行肺叶切除术肺癌患者36例，随机分为长时间组（Ⅰ组）和间断的双肺通气组（Ⅱ组），每组18例。两组患者分别在麻醉诱导后（T1）、OLV 45 min（T2）、90min（T3）及术后2h（T4）采取静脉血，测定血清肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-8、IL-10浓度。结果两组TNF-α、IL-6、IL-8和IL-10于T2时明显上升（P〈0．05），Ⅱ组T3、T4时TNF-α、IL-6和IL-8均明显低于Ⅰ组（P〈0．05），而IL-10高于Ⅰ组（P〈0．05）。结论单肺通气期间间断双肺通气可减轻炎性反应。

Effect of the different modes of one lung ventilation on inflammatory factors during operation

Objective To observe the effect of the different modes of one lung ventilation （OLV） on inflammatory factors during operation. Methods 36 patients with lung cancer undergoing lung resection were randomly divided into two groups with 18 cases each： long time group （ group Ⅰ ） and intermittent two lung ventilation （ group Ⅱ ）. Blood samples were taken after induction of anesthesia （T1 , baseline）, at OLV 45 min （ T2 ）, OLV 90 min （ T3 ） and 2 h after operation （ T4 ） for determination of serum TNF-α, IL-6, IL-8 and IL- 10 concentrations. Results Serum TNF-α, IL-6, IL-8 and IL-10 concentrations were all significantly increased at T2 （ P 〈 0. 05 ）. Serum TNF-ct, IL-6 and IL-8 concentrations were lower at T3 -4 and IL-0 was higher in group Ⅱ than those in the group I （P 〈 0. 05 ）. Conclusion Intermittent two lung ventilation could alleviate the pulmonary inflammatory reactions during OLV.