乌司他丁预处理对食管癌根治术麻醉所致炎性肺损伤的保护作用  

Protective Effect of Ulinastatin Pretreatment on Inflammatory Pulmonary Injury Induced by anesthesia for Esophageal Cancer Radical Operation

作　　者：李志琴 来伟 孟海兵 LI Zhi-qin;LAI Wei;MENG Hai-bing(Department of Anesthesiology,908 Hospital of PLA Joint Logistic Support Forces,Nanchang 330002,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院麻醉科,南昌330002

出　　处：《解放军医药杂志》2019年第1期18-21,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：江西省卫生计生委科技计划(20175569)

摘　　要：目的探讨乌司他丁与甲强龙预处理对食管癌根治术麻醉所致炎性肺损伤的保护作用。方法选择2016年2月—2018年3月收治的食管癌并行根治术的患者110例,根据给药不同分为甲强龙组和乌司他丁组,每组55例。观察2组麻醉诱导前(T0)、单肺通气1和2 h(T1和T2)及术后2 h肺功能指标和炎性因子水平变化情况。结果2组T1和T2时点动脉氧分压(Pa O2)和氧合指数(OI)均低于T0时点,但乌司他丁组高于甲强龙组(P <0. 05); 2组T1和T2时点二氧化碳分压(Pa CO2)高于T0时点,但乌司他丁组低于甲强龙组(P <0. 05);乌司他丁组T3时点Pa O2和OI高于甲强龙组,Pa CO2低于甲强龙组(P <0. 05)。2组T1和T2时点肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、IL-8和IL-10水平高于T0时点,乌司他丁组TNF-α、IL-6、IL-8水平低于甲强龙组,但IL-10高于甲强龙组(P <0. 05); 2组T3时点炎性因子水平均高于T0时点,乌司他丁组TNF-α、IL-6、IL-8水平低于甲强龙组,但IL-10水平高于甲强龙组(P <0. 05)。结论在食管癌根治术麻醉所致肺损伤方面乌司他丁较甲强龙具有更强的肺部保护作用。Objective To investigate protective effects of Ulinastatin and Methylprednisolone pretreatment on inflammatory pulmonary injury induced by anesthesia for esophageal cancer radical operation.Methods A total of 110 patients with esophageal cancer undergoing radical operation admitted during February 2016 and March 2018 were divided into Methylprednisolone group and Ulinastatin groups(n=55 for each group)according to drug administrations.Changes of pulmonary function indexes and inflammatory factor levels before anesthesia induction(T0),one-lung ventilation for 1 and 2 h(T1 and T2)and in 2 h after operation were observed in two groups.Results Levels of arterial oxygen pressure(PaO2)and oxygenation index(OI)at T1 and T2 were significantly lower than those at T0 in two groups,but the levels in Ulinastatin group were significantly lower than those in Methylprednisolone group(P<0.05).Partial pressure of carbondioxide(PaCO2)levels at T1 and T2 were significantly higher than those at T0 in two groups,but the level in Ulinastatin group was significantly lower than that in Methylprednisolone group(P<0.05).At T3,in Ulinastatin group PaO2 and OI levels were significantly higher,while PaCO 2 levels were significantly lower than those in Methylprednisolone group(P<0.05).The ulinastatin group was better than the methylprednisolone group(P<0.05).At T1 and T2,levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8 and IL-10 were significantly higher than those at T0 in two groups(P<0.05);in Ulinastatin group,TNF-α,IL-6 and IL-8 levels were significantly lower,while IL-10 level was significantly higher than those in Methylprednisolone group(P<0.05).At T3,inflammatory factor levels were significantly higher than those at T0 in two groups;in Ulinastatin group,TNF-α,IL-6 and IL-8 levels were significantly lower,while IL-10 level was significantly higher than those in Methylprednisolone group(P<0.05).Conclusion Ulinastatin has better protective effect for pulmonary injury induced by anesthesia for esophageal cancer radica

关 键 词：乌司他丁 食管肿瘤 麻醉 肺损伤 

分 类 号：R735.1[医药卫生—肿瘤]