小剂量呋塞米对胸腔镜下肺切除术患者肺换气功能及预后的影响

目的：观察全麻期间给予小剂量呋塞米对胸腔镜下肺切除术后肺换气功能及预后的影响。方法：纳入择期行胸腔镜下肺切除术患者150例。采用随机数表法将患者分为呋塞米组（F组）和对照组（C组），每组75例。F组于手术结束前0.5 h静脉推注呋塞米0.1 mg·kg-1，C组于手术前0.5 h静脉推注等体积生理盐水0.1 mL·kg-1。记录患者术后2 h和24 h动脉血气氧分压、氧合指数、电解质水平、肺部并发症情况及30天内死亡情况。结果：与C组比较，F组术后2 h及24 h动脉血氧分压和氧合指数明显改善（P < 0.05），术后K+、Na+、Ca2+及Cl-水平、肺部并发症发生率以及术后30天内死亡率差异均无统计学意义（P > 0.05）。结论：全麻期间给予小剂量呋塞米（0.1 mg·kg-1）可以改善胸腔镜下肺切除患者术后24 h内肺换气功能，但并不能降低术后肺部并发症发生率及30天内死亡率。

Effects of Low Dose Furosemide on Pulmonary Gas Exchange Function and Prognosis in Patients Post Thoracoscopic Pulmonary Resection

Objective: To observe the effects of low-dose furosemide administration during general anesthesia on postoperative pulmonary gas exchange function and prognosis in patients with thoracoscopic pulmonary resection. Methods: A total of 150 patients selected for thoracoscopic pulmonary resection were divided into two groups by a random number table method: furosemide group (group F) and control group (group C), with 75 patients in each group. Patients of the group F were intravenously injected with 0.1 mg·kg-1 furosemide half an hour before the end of surgery, and those of the group C were intravenously injected with equal volume normal saline 0.1 mL·kg-1. Arterial blood gas oxygen partial pressures, oxygenation indexes and electrolyte levels were recorded at 2 h and 24 h after surgery, pulmonary complications and death within 30 days were also recorded. Results: Compared with the group C, the oxygen partial pressures and oxygenation indexes in the group F were significantly improved at 2 h and 24 h after operation (P < 0.05), while no difference was found in levels of K+, Na+, Ca2+ or Cl- after surgery, incidence of postoperative pulmonary complications or mortality within 30 days after surgery (P > 0.05). Conclusion: Small dose of furosemide (0.1 mg·kg-1) during general anesthesia can improve pulmonary gas exchange function within 24 h after thoracoscopic pulmonary resection, but cannot reduce the incidence of postoperative pulmonary complications and mortality within 30 days.