胸内手术患者单肺通气时超氧化物歧化酶的变化及意义

目的探讨胸内手术患者单肺通气时超氧化物歧化酶(SOD)的变化及意义。方法剖胸手术患者30例,随机分为两组,单肺通气组(OLV组)15例和双肺通气组(TLV组)15例,于麻醉诱导前(T0)、单肺通气前即刻(T1)、单肺通气0.5 h(T2)、1 h(T3)、2 h(T4)、恢复双肺通气1 h(T5)、2 h(T6)和术后24 h(T7),双肺通气组T1～7对应时点为手术剖开胸腔时、胸内操作0.5 h、1 h、2 h、胸内操作完成后1 h、2 h,术后24 h,采集桡动脉血样,测定血清SOD的活性,白细胞(WBC)和中性粒细胞(PMN)计数。结果与T0比较,两组的SOD活性均在T5、T6下降(P<0.05);WBC及PMN计数:OLV组在T4～T7、TLV组T5～T7升高(P<0.05)。与TLV组比较,OLV组T5～T7时SOD活性降低,PMN计数升高,T4～T7时WBC计数升高(P<0.05)。结论单肺通气比双肺通气更易诱发或加重机体的氧化应激反应。

Change and Significance of Superoxide Dismutase During One-lung Ventilation in Patients Undergoing Thoracic Surgery

Objective To investigate the change and significance of superoxide dismutase(SOD) during one-lung ventilation in patients undergoing thoracic surgery.Methods Thirty cases undergoing thoracic surgery were divided into two groups randomly,one lung ventilation group(n=15,OLV group) and two-lung ventilation group(n=15,TLV group).The activity of SOD,white blood cell(WBC) and polymorphonuclear neutrophils(PMN) counts were detected before induction of anesthesia(T0),at the moment of one-lung ventilation(T1),0.5 hour(T2),1 hour(T3),2 hours(T4) after one-lung ventilation,1 hour(T5),2 hours(T6) after the recovery of two-lung ventilation and 24 hours(T7) after the surgery in OLV group,and the detection was also performed in the TLV group at the moment of opening chest(T1),30 minutes(T2),1 hour(T3),2 hours(T4) after beginning of surgery and 1 hour(T5),2 hours(T6),24 hours(T7) after the end of surgery.Results Compared with T0,the activity of SOD decreased at T5 and T6 in the two groups(P<0.05);WBC and PMN increased at T4-T7 in OLV group and at T5-T7 in TLV group(P<0.05).Compared with TLV group,the activity of SOD decreased at T5-T7 in OLV group,while PMN increased;WBC increased at T4-T7(P<0.05).Conclusion Compared with two-lung ventilation,one-lung ventilation stimulates and aggravates oxidative stress of organism much more easily.