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目的探讨盐酸戊乙奎醚(PH)对食管癌根治术患者围术期炎性反应的影响。方法择期食管癌根治术患者40例,随机分为盐酸戊乙奎醚组(P组)和对照组(C组),每组20例。麻醉诱导前5min,P组患者静脉注射PH0.05mg/kg(以生理盐水稀释至10ml);C组则给予同等剂量的生理盐水。分别于麻醉诱导前10min(T1),气管插管后10min(T2)(单肺通气OLV前),OLV30 min(T3)、90 min(T4)及再次双肺通气10 min(T5)由中心静脉采血4ml,以酶联免疫法分别测血浆中TNF-α、IL-8和IL-10的浓度。结果与T1、T2相比,两组患者血浆TNF-α、IL-8和IL-10水平T3时开始升高、T5时达峰值,差异有统计学意义(P<0.05);P组T3至T5时刻血浆TNF-α和IL-8水平均低于C组,而IL-10水平均高于C组,差异有统计学意义(P<0.05)。结论盐酸戊乙奎醚在食管癌根治术患者围术期中可明显降低TNF-α和IL-8,升高IL-10,减轻肺部损伤,对临床实践中肺保护具有一定的积极作用。
Objective To investigate the effect of penehyclidine hydrochloride (PH) on the perioperative inflammatory response in patients undergoing radical resection of esophageal cancer. Methods Forty patients with elective esophageal cancer were randomly divided into penehyclidine hydrochloride group (P group) and control group (C group), with 20 cases in each group. 5 minutes before induction of anesthesia, P group patients intravenous injection of PH0.05mg / kg (diluted with saline to 10ml); C group was given the same dose of saline. The venous blood samples were collected from the central venous before 10 minutes (T1), 10 minutes (T2) (before OLV), 30 minutes (T3), 90 minutes (T4) Blood was collected 4ml, respectively, by enzyme-linked immunosorbent assay plasma concentration of TNF-α, IL-8 and IL-10. Results Compared with T1 and T2, plasma TNF-α, IL-8 and IL-10 levels in both groups increased at T3 and reached the peak at T5 (P <0.05) T5 plasma TNF-α and IL-8 levels were lower than the C group, while the IL-10 levels were higher than the C group, the difference was statistically significant (P <0.05). Conclusion Penehyclidine hydrochloride can reduce TNF-α and IL-8, increase IL-10, and reduce lung injury in patients undergoing radical resection of esophageal cancer. It has a positive effect on lung protection in clinical practice.