静脉硫酸镁对食管癌根治术单肺通气患者氧化应激反应的影响  

Effects of Magnesium Sulfate Infusion on Oxidative Stress in Patients Undergoing Esophagogastrostomy with One Lung Ventilation

作　　者：程芳[1] 孟凡珍[2] 颜凤凤[1] 万军芳[1] 

机构地区：[1]连云港市东方医院,江苏省连云港市222042 [2]连云港市第二人民医院

出　　处：《医学理论与实践》2018年第2期166-168,共3页The Journal of Medical Theory and Practice

基　　金：连云港市卫计委课题(局1423)

摘　　要：目的:观察静脉输注硫酸镁对食管癌根治术单肺通气(One lung ventilation,OLV)患者氧化应激反应的影响。方法:60例择期在全身麻醉下行食管癌根治术单肺通气患者随机分为硫酸镁组(MG组)和生理盐水组(NS组),每组30例。MG组于麻醉开始时静脉输注硫酸镁负荷量25mg/kg,输注时间为30min,然后以12.5mg·kg-1·h-1持续输注至手术结束;NS组持续输注等容积的生理盐水。于麻醉诱导前、OLV即刻、OLV 30min,OLV 90min,膨肺后30min(TLV 30min)及术后2h的6个时间点记录HR、SBP、DBP和SpO2值;采血测定血清镁离子浓度、丙二醛(MDA)和超氧化物歧化酶(SOD)水平;记录术中麻黄碱和阿托品的使用次数。结果:术后2h两组HR、SBP均升高(P<0.05、P<0.01),且MG组低于NS组(P<0.05、P<0.01)。术中两组SpO2于OLV前即刻及TLV 30min均明显高于麻醉诱导前(P<0.05),但两组间比较差异无统计学意义(P>0.05)。MG组的血清镁离子在OLV前即刻明显高于麻醉诱导前(P<0.05),并高于NS组(P<0.01)。两组MDA水平在术中术后各时点均明显高于麻醉诱导前(P<0.01),且MG组低于NS组(P<0.05)。两组SOD水平在术中术后各时点均明显低于麻醉诱导前(P<0.05),且MG组高于NS组(P<0.05)。两组患者术中麻黄碱和阿托品使用次数比较差异无统计学意义(P>0.05)。结论:食管癌根治术OLV患者静脉输注硫酸镁可以减弱OLV导致的氧化应激反应。Objective:To observe the effects of magnesium sulfate infusion on oxidative stress in patients undergoing esophagogastrostomy with one lung ventilation(OLV).Methods:60 patients undergoing esophagogastrostomy with OLV were randomized in two groups(magnesium sulfate:group MG,n=30 and normal saline:group NS,n=30).The patients in group MG received magnesium sulfate 25 mg·kg^(-1) intravenously for 30 min before anaesthesia and continuous infusion of 12.5 mg·kg^(-1)·h^(-1) the end of the surgery.The patients in Group NS received the same volume of saline.HR,SBP,DBP and SpO_2 were recorded at induction of anaesthesia,beginning of OLV,OLV 30 min,OLV 90 min,after two lung ventilation(TLV 30 min)and postoperative 2 h.The concentration of Mg^(2+) and level of malondialdehyde(MDA),superoxide dismutase(SOD)in serum were metered.The use of ephedrine and atropine were recorded.Results:HR and SBP at postoperative 2 hwere significantly higher than those at induction of anaesthesia(P<0.05,P<0.01),but those in group MG were lower than those in group NS(P<0.05,P<0.01).SpO_2 was significantly higher at beginning of OLV than that at induction of anaesthesia and TLV 30 min(P<0.05).There were no significant differences between the two groups(P>0.05).In group MG,the concentrations of Mg^(2+) in plasma was higher at beginning of OLV than that at induction of anaesthesia(P<0.05),and it was higher than that in group NS(P<0.01).The level of MDA was significantly higher at each time point than that at induction of anaesthesia(P<0.01),it was lower in group MG than that in group NS(P<0.05).The level of SOD was significantly lower at each time point than that at induction of anaesthesia(P<0.05),it was higher in group MG than that in group NS(P<0.05).There were no significant differences in use of ephedrine and atropine between the two groups(P>0.05).Conclusion:The infusion of magnesium sulfate may offer protection against oxidative stress in patients undergoing esophagogastrostomy with OLV.

关 键 词：硫酸镁 单肺通气 丙二醛 超氧化物歧化酶 

分 类 号：R735.1[医药卫生—肿瘤]