七氟烷和丙泊酚对单肺通气下行食管癌根治术患者炎症反应及肺功能的影响

目的研究单肺通气下行食管癌根治术中使用丙泊酚和七氟烷对患者炎症反应及肺功能的影响。方法选择2012年1月²014年6月在我院接受食管癌根治手术的患者92例作为研究对象。根据数字法将患者随机分成丙泊酚组(A组,46例)与七氟烷组(B组,46例)。对比两组患者在不同时间点的肺泡-动脉氧分压差(PA-a O2)、氧合指数(OI)及呼吸指数(RI)水平,两组患者在不同时间点的血浆IL-1及NF-k B DNA结合活性水平以及两组患者在围手术期发生感染的情况。结果与T0相比,B组T2、T3及T4的PA-a O2水平均增加;与T0相比,两组T22014年6月在我院接受食管癌根治手术的患者92例作为研究对象。根据数字法将患者随机分成丙泊酚组(A组,46例)与七氟烷组(B组,46例)。对比两组患者在不同时间点的肺泡-动脉氧分压差(PA-a O2)、氧合指数(OI)及呼吸指数(RI)水平,两组患者在不同时间点的血浆IL-1及NF-k B DNA结合活性水平以及两组患者在围手术期发生感染的情况。结果与T0相比,B组T2、T3及T4的PA-a O2水平均增加;与T0相比,两组T2⁵的OI水平均下降;与T0相比,A组T25的OI水平均下降;与T0相比,A组T2⁵的RI及B组T25的RI及B组T2⁶的RI水平均增加;与B组相比,A组T36的RI水平均增加;与B组相比,A组T3⁷的RI水平均降低,差异均有统计学意义(均p<0.05)。与T0相比,两组T3及T6的血浆IL-1水平均显著升高;与T0相比,B组T7的血浆IL-1水平上升;与B组相比,A组T2、T3、T6及T7的血浆IL-1水平显著降低;与T0相比,两组T6及T7的NF-k B DNA结合活性水平显著上升;与B组相比,A组T1及T7的NF-k B DNA结合活性水平显著下降,差异均有统计学意义(均p<0.05)。两组围手术期的感染率对比,差异无统计学意义(p>0.05)。结论单肺通气下实施食管癌根治手术时应用丙泊酚麻醉对患者的炎性反应以及肺功能的影响更小。

INFLAMMATORY RESPONSE AND LUNG FUNCTION OF EFFECTS ON PATIENTS UNDER ONE - LUNG VENTILATION WITH ESOPHAGEAL CANCER RADICAL OF PROPOFOL AND SEVOFLURANE

Objective To study inflammatory response and lung function of effects on patients under one - lung ventilation with esophageal cancer radical of propofol and sevoflurane. Methods 96 cases of patients undergo- ing esophageal cancer radical surgery between January 2012 and June 2014 in our hospital were chosen as the research object. According to the digital method, they were randomly divided into propofol group （ A group,46 cases） and sevoflurane group （B group ,46 cases）. Two groups of patients at different time points of PA - aO2, OI and RI lev- el, two groups of patients at different time points of plasma IL - 1 and NF - kB DNA binding activity levels and two groups of patients in perioperative infection, were compared. Results Compared with the TO, sevoflurane group＇s T2, I3, and T4 PA - aO2 level increased ; Compared with the ri0, two groups of T2 ~ 50I level decreased; Com- pared with TO, propofol group＇s T2 - 5 RI and sevoflurane group＇s T2 - 6 RI level increased; Compared with sevoflurane group and propofol group＇s 33 - 7 levels of RI, all were statistically significant differences （all p 〈 0. 05）. Compared with the TO, two groups of T3 and T6 were significantly higher leels of plasma IL - 1 ; Compared with the TO sevoflurane T7 had set of plasma IL - 1 levels; Compared with sevoflurane group, propofol group＇s T2, 33, T6, T7 had significantly reduced leels of plasma IL - 1 ; Compared with the TO, two groups of T6 or T7 had NF - kB DNA binding activity levels increased significantly; Compared with sevoflurane group, propofol group＇s T1 and NF - kB of T7 had a significant reduction in the level of DNA binding activity. The differences were statistically significant （ all p 〈 0.05 ）. There was no statistically significant difference in perioperative infection （p 〉 0.05 ）. Conclusion By single lung ventilation when implementing esophageal cancer radical surgery under the application of propofol anesthesia on the influence of the inflammatory response and lung function in p