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乌司他丁对食管癌根治术中肺损伤的保护作用
引用本文:何君艺,王彦,胡大伟.乌司他丁对食管癌根治术中肺损伤的保护作用[J].新疆医科大学学报,2012,35(1):68-70,74.
作者姓名:何君艺  王彦  胡大伟
作者单位:农六师五家渠市人民医院麻醉科,新疆,五家渠,831300
摘    要:目的 探讨乌司他丁在全麻食管癌根治术单肺通气(OLV)中的肺保护作用及其机制.方法 全麻OLV下食管癌根治术患者40例,随机分为乌司他丁组(A组)和对照组(B组),每组20例.A组OLV开始后,静脉泵注乌司他丁10 000 IU/kg,1 h内注完;B组给予等量生理盐水.两组分别在麻醉诱导后(T0)、OLV 后1 h(T1)、OLV 后2 h(T2)、术后2 h(T3)及术后24 h(T4)5个时点采集动脉血,检测HMGB1、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)浓度.结果 两组T0时点的HMGB1、TNF-α、IL-6 、IL-8、IL-10的血清浓度无明显差异(P>0.05);两组病人T1、T2、T3、T4时点与T0比较HMGB1、TNF-α、IL-6 、IL-8、IL-10血清浓度显著升高,差异具有统计学意义(P<0.05);与B组相比,A组T1、T2、T3、T4时点HMGB1、TNF-α、IL-8水平显著降低(P<0.05),IL-10水平明显升高(P<0.05).结论 乌司他丁显著增加食管癌根治术OLV患者血清IL-10的浓度,抑制HMGB1、TNF-α、IL-6 、IL-8浓度的升高,在食管癌根治术OLV过程中起肺保护作用.

关 键 词:单肺通气  乌司他丁  肺保护作用

Protective effect of Ulinastatin on radical surgery for esophageal cancer on the lung injury
HE Jun-yi,WANG Yan,HU Da-wei.Protective effect of Ulinastatin on radical surgery for esophageal cancer on the lung injury[J].Journal of Xinjiang Medical University,2012,35(1):68-70,74.
Authors:HE Jun-yi  WANG Yan  HU Da-wei
Institution:(Department of Anesthesiology,People′s Hospital of Wujiaqu,Wujiaqu 831300,China)
Abstract:Objective To explore the lung protective effect of ulinastatin(UTI) on esophagus cancer resection during one lung ventilation.Methods Fourty esophagus cancer resection patients were divided into two groups randomly.Ulinastatin group A(n=20): ulinastatin 10 000 U/kg intravenous infusion continually during esophagus cancer resection in one hou;and the patients control group B(n=20): the same volume of normal saline as in group A instead of ulinastatin.Blood concentrations of HMGB1、TNF-α,IL-6,IL-8,IL-10 were tested at post-induction of anesthesia(T0);one hour after one-lung ventilation(T1);two hours after one-lung ventilation(T2);two hours after operation(T3);24 hours after operation(T4).Results There were no marked differences in HMGB1,TNF-α,IL-6,IL-8 and IL-10 levels at T0 in both groups(P>0.05).Compared with T0,T1,T2,T3,T4 there are significant decrease in HMGB1、TNF-α,IL-6,IL-8,IL-10(P<0.05)in both groups.Compared with group B,HMGB1、TNF-α、IL-6 and IL-8 levels were lower at T1,T2,T3,T4(P<0.05) in the group A,but the level of IL-10 was higher(P<0.05).Conclusion Ulinastatin significantly increased in patients with esophageal cancer resection OLV serum IL-10 concentrations,inhibition of HMGB1,TNF-α,IL-6,IL-8 concentration,and radical surgery in esophageal cancer from the lung protection during OLV the role.
Keywords:one-lung ventilation  ulinastatin  lung protection effect
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