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目的探讨异丙酚对肺癌切除术患者围术期肺功能与炎性反应的影响。方法根据麻醉方案将125例肺叶切除术肺癌患者分为观察组(67例)与对照组(58例)。观察组患者采用静脉注射异丙酚、维库溴铵、芬太尼行诱导麻醉,采用静脉注射异丙酚行维持麻醉。对照组患者采用吸入七氟烷,静脉注射维库溴铵、芬太尼行诱导麻醉,采用吸入七氟烷行维持麻醉。对比分析诱导麻醉前(T_0)、单肺通气开始前(T_1)、单肺通气结束(T_2)、关胸(T_3)、术后24h(T_4)两组患者的肺功能指标与炎性反应指标。结果 1 T_0、T_1、T_4,两组患者肺泡-动脉氧分压差(A-a DO2)、呼吸指数(RI)、肺内分流率(Qs/Qt)差异无统计学意义(P>0.05)。T_2、T_3,观察组患者A-a DO2、RI、Qs/Qt均显著低于对照组(P<0.05)。2 T_0、T_4,两组患者基质金属蛋白酶-9(MMP-9)差异无统计学意义(P>0.05)。T_1、T_2、T_3,观察组患者MMP-9显著低于对照组(P<0.05)。结论肺癌切除术应用异丙酚对患者围术期肺功能的影响较小,肺部炎性反应较低,值得临床推广应用。
Objective To investigate the effects of propofol on pulmonary function and inflammatory response in patients undergoing resection of lung cancer. Methods 125 patients with lung cancer undergoing lobectomy were divided into the observation group (67 cases) and the control group (58 cases) according to the anesthesia protocol. Patients in the observation group were given intravenous propofol, vecuronium and fentanyl for induction of anesthesia. Intravenous propofol was used to maintain anesthesia. Patients in the control group were induced to sevoflurane by inhalation of sevoflurane, intravenous vecuronium and fentanyl, and inhalation of sevoflurane to maintain anesthesia. The pulmonary function and inflammatory response indexes of two groups before induction (T 0), before one lung ventilation (T 1), after one lung ventilation (T 2), off chest (T 3) and after 24h . Results There was no significant difference of A-a DO2, RI and Qs / Qt between T0, T_1 and T_4 in the two groups (P> 0.05). T_2, T_3, A-a DO2, RI, Qs / Qt in observation group were significantly lower than those in control group (P <0.05). 2T_0, T_4, there was no significant difference between the two groups in the level of matrix metalloproteinase-9 (P> 0.05). T_1, T_2, T_3, MMP-9 in observation group was significantly lower than that in control group (P <0.05). Conclusion The application of propofol in lung cancer resection has less effect on the lung function in patients during perioperative period and low inflammatory reaction in the lung, which is worthy of clinical application.