七氟烷和丙泊酚麻醉对肺癌患者围术期肺功能的影响与比较

摘要： 目的 分析七氟烷与丙泊酚对肺癌患者围术期肺功能恢复影响与对照。方法 本次研究均为肺癌患者,所有患者均需行开胸单纯性左肺下叶切除手术,共从中选择36例参与本次研究。麻醉方法随机分为七氟烷组和丙泊酚组,每组18例,年龄35-60岁。七氟烷组术中采用七氟烷实施麻醉维持,丙泊酚组术中采用丙泊酚实施麻醉维持,分别在单肺通气诱导前和麻醉诱导前以及单肺即刻等时间段对患者做血气分析,分析过程中取混合静脉血和桡动脉血,然后对各项相关指标进行计算。结果 1.两组患者在T1-3 时A-aDO2、RI、Qs/Qt均较T1显著增加（P<0.05）2.与T1比较,七氟烷组T3时Cdyn显著降低（P<0.05）,丙泊酚组T3时无显著性差异。3.与丙泊酚组相比较,七氟烷组T2,3时A-aDO2增加（P<0.05）;T2,3时RI增加（P<0.05）;T1-3时Qs/Qt增加（P<0.05）。结论 肺癌患者手术采用丙泊酚维持麻醉,对患者肺功能影响较七氟烷小,利于术后肺功能恢复。

Effects of sevoflurane and propofol anesthesia on pulmonary function in patients with lung cancer during perioperative period

Abstract: Objective To analyze the effect and comparison of sevoflurane and propofol on lung function in patients with lung cancer during perioperative period. Methods 36 patients with lung cancer with simple left lobectomy were randomly divided into Sevoflurane Group and propofol Group, 18 cases in each group and 35-60 years old. Sevoflurane was used to maintain anesthesia during the operation of sevoflurane group, and propofol was used to maintain anesthesia during the operation of propofol Group. The moment before anesthesia induction (T0), before the start of single lung ventilation (T1), before the end of single lung ventilation (T2), after closed chest surgery (T3) and postoperative 24h (T4), take radial artery and mixed Venous blood, do gas analysis, calculate alveolar-arterial oxygen difference (A-ADO2), respiration Index (RI), and intrapulmonary shunt Rate (QS/QT). Results 1. A-aDO2, RI and QS/QT were significantly increased in the T1-3 of two groups (p<0.01). 2. Compared with T1, Cdyn significantly decreased (p<0.05) in T3 group, and no significant difference was occurred in the T3 of Propofol group. 3. Compared with the group of Propofol, A-aDO2 increased (p<0.05) in the T2,3 of sevoflurane group. RI increases when T2,3 (p<0.05); QS/QT Increase (p<0.05) when T1-3. Conclusion The operation of patients with lung cancer using propofol to maintain anesthesia, the lung function of patients with less influence than sevoflurane, conducive to postoperative pulmonary function recovery.