盐酸纳布啡对单肺通气患者术中血浆TNF-α和IL-6的影响  

Effects of nalbuphine hydrochloride on tumor necrosis factor-α and interleukin-6 during one lung ventilation

作　　者：张郃[1] 李青春[2] 龙超[1] 

机构地区：[1]湖北省咸宁市中心医院湖北科技学院附属第一医院麻醉科,湖北咸宁437100 [2]湖北科技学院五官医学院眼科教研室,湖北咸宁437100

出　　处：《中国当代医药》2016年第32期115-117,共3页China Modern Medicine

摘　　要：目的 探讨盐酸纳布啡对胸腔镜肺叶切除术患者单肺通气（OLV）时血浆中肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）的影响。方法 选取2016年4～8月我院择期胸腔镜肺叶切除术患者44例,采用随机数字表法,将其随机分为两组（n=22）,分别于诱导前静脉注射盐酸纳布啡0.2 mg/kg（N组）和等量生理盐水（C组）。两组于诱导前（T0）、双肺通气后20 min（T1）、OLV 30 min（T2）、OLV 60 min（T3）及再次双肺通气后10 min（T4）时采集静脉血样,测定血清中TNF-α和IL-6的浓度。结果 两组患者血清TNF-α水平在T3、T4时均较T0高（P〈0.05）,N组TNF-α水平在T3、T4时较C组低（P〈0.05）;两组患者血清IL-6水平在T4时均高于T0（P〈0.05）,N组IL-6水平在T4时较C组低（P〈0.05）。结论 麻醉诱导前静脉注射盐酸纳布啡0.2 mg/kg可抑制胸腔镜肺叶切除手术患者术中血清TNF-α和IL-6水平升高,可明显降低患者OLV期间的炎性反应。Objective To explore the effects of nalbuphine hydrochloride on Tumor necrosis factor-α（TNF-α） and Interleukin-6（IL-6）for patients undergoing thoracoscopic lobectomy during one lung ventilation（OLV）.Methods Fortyfour patients were selected form April to August 2016,undergoned open radical esophagectomy and were randomly divided into two groups（n =22）.One group was received intravenous infusion of nalbuphine hydrochloride 0.2 mg/kg（Group N） and the other group was received the same volume of saline in the same way（Group C） before induction of anesthesia.Blood samples were collected before the anesthesia induction（T0）,20 min after two lung ventilation（T1）,at 30 min（T2）,60 min（T3） after OLV and 10 min after again two lung ventilation（T4） for determination of serum TNF-α and IL-6concentrations.Results Compared with T0,the level of TNF-α at T3,T4 and the level of IL-6 at T4 were significantly increased in the two groups（P〈0.05）.Compared with Group C,the level of TNF-α at T3,T4 and the level of IL-6 at T4 were significantly decreased in Group N（P〈0.05）.Conclusion Intravenous nalbuphine hydrochloride 0.2 mg/kg before induction of anesthesia can inhibit the level of TNF-α and IL-6 and reduce inflammatory response in the patients undergoing thoracoscopic lobectomy with OLV.

关 键 词：盐酸纳布啡 单肺通气 肿瘤坏死因子-Α 白细胞介素-6 

分 类 号：R563[医药卫生—呼吸系统]