七氟醚和丙泊酚对支气管黏液纤毛运输功能的影响  

Effect of sevoflurane and propofol on bronchial mucociliary transport

作　　者：印春铭[1] 赵芸慧[2] 何芳[1] 王俊科[2] 

机构地区：[1]中国医科大学附属第四医院麻醉科,辽宁沈阳110032 [2]中国医科大学附属第一医院麻醉科,辽宁沈阳110032

出　　处：《中国医科大学学报》2006年第6期639-641,共3页Journal of China Medical University

基　　金：辽宁省教育厅高等学校科研基金资助项目(05L562);沈阳市科技计划基金资助项目(1053125-1-54)

摘　　要：目的:观察七氟醚吸入麻醉和丙泊酚静脉麻醉对支气管黏液纤毛运输速度的影响。方法:选择40例ASAⅠ～Ⅱ级择期腹部手术病人,随机分为2组,每组20例。一组5%七氟醚吸入麻醉,另一组丙泊酚静脉麻醉,2组病人分别在机械通气10和60 min后测量支气管黏液纤毛运输速度。小儿支气管镜直视下,在右主支气管背部黏膜上方通过硬膜外导管注射亚甲蓝,标记染料在0、2、4、6 min的移动距离,计算支气管黏液纤毛运输速度。结果:七氟醚组在机械通气10和60 min后黏液纤毛的运输速度分别为(14.0±2.2)和(12.7±2.1)mm/min,通气60 min较通气10 min黏液纤毛的运输速度显著下降(P<0.05)。丙泊酚组在通气10和60 min后黏液纤毛的运输速度分别为(14.1±2.1)和(14.2±2.0)mm/min,无统计学差异。2组在机械通气10 min后比较,黏液纤毛运输速度的差异无统计学意义;通气60 min后比较,丙泊酚组黏液纤毛的运输速度显著高于七氟醚组(P<0.05)。结论:七氟醚抑制支气管黏液纤毛运输功能,丙泊酚对黏液纤毛运输功能没有影响。Objective： To investigate the effect of inhalation anesthesia with sevoflurane and inwavenous anesthesia with propofol on bronchial mucociliary transport. Methods： Forty patients with American Society of Anesthesiologist （ASA） physical status classification Ⅰ to Ⅱ were randomly divided into 2 groups,in which the patients underwent inhalation anesthesia with 5% sevoflurane and intravenous anesthesia with propofol,respectively, Bronchial mucus transport velocity （BIT） was measured 10 and 60 minutes after mechanical ventilation. An 18- gauge epidural catheter was inserted into right main bronchus,and 0,015 ml of methylene blue dye was injected onto the posterior surface of right main bronchus under pediatric fiberopfic bronchoscope. The travel distances of the dye were determined 2,4, and 6 minutes after the administration of the dye, and BTV was calculated, R~： In sevoflurane group, BTV measured 60 minutes after mechanical ventilation was significantly lower than that measured 10 minutes after mechanical ventilation （12.7±2.1 vs. 14.0±2.2 mm/min,P 〈 0,05）, In propofol group,BTV was 14.1±2.1 mm/min 10 minutes after mechanical ventilation and 14.2±2.0 mm/min 60 minutes after mechanical ventilation, and no significant difference was found, There was no significant difference in BTV measured 10 minutes after mechanical ventilation between sevoflurane and propofol groups, but BTV measured 60 minutes after mechanical ventilation in propofol group was significantly higher than that in sevoflurane group（P 〈 0.05 ）, Condusion：Sevoflurane could inhibit the bronchial muceciliary transport,but propofol has no effect on bronchial mucociliary transport.

关 键 词：支气管 黏膜纤毛清除 七氟醚 二异丙酚 

分 类 号：R614.2[医药卫生—麻醉学]