参麦注射液对脓毒症全身麻醉患者血清炎症因子及血气分析指标的影响  

Effect of Shenmai Injections on serum inflammatory factors and blood gas analysis indicators in patients with sepsis undergoing general anesthesia

作　　者：覃淼 林雅丽[1] 石俊丹 杨宜科[1] QIN Miao;LIN Ya-li;SHI Jun-dan;YANG Yi-ke(Department of Anesthesiology,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学第一附属医院麻醉科

出　　处：《广西医学》2019年第13期1634-1637,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z20180537)

摘　　要：目的 探讨参麦注射液对脓毒症全身麻醉患者血清炎症因子及血气分析指标的影响。方法 选择 88例行全身麻醉急诊手术的脓毒症患者,按随机数字表法分为对照组和观察组各44例。两组患者均行常规机械通气、麻醉维持,观察组术中给予静脉滴注1 mL/kg参麦注射液,对照组给予等量0.9%氯化钠注射液。比较两组患者在麻醉诱导前(T 0)、手术开始后30 min(T 1)、手术结束时(T 2)、手术结束后24 h(T 3)的血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平及PaO 2、PaCO 2、吸入氧气分数(FiO 2)。结果 两组患者的血清TNF-α、IL-6水平及PaO 2、PaCO 2、FiO 2比较,差异均有统计学意义( P <0.05),两组患者以上指标均有随时间变化的趋势( P <0.05),分组与时间有交互效应( P <0.05),其中观察组患者在T 1、T 2、T 3时的PaO 2高于对照组,PaCO 2、FiO 2及血清TNF-α、IL-6水平均低于对照组(均 P <0.05)。结论 参麦注射液应用于脓毒症患者全身麻醉手术中,可降低炎症因子水平,改善血气分析指标,对肺功能具有一定保护作用.Objective To investigate the effect of Shenmai Injections on serum inflammatory factors and blood gas analysis indicators in sepsis patients undergoing general anesthesia.Methods Eighty-eight patients with sepsis who underwent emergency surgery under general anesthesia were divided into control group and observation group according to random number table method,with 44 cases in each group.Both groups were given routine mechanical ventilation and anesthesia maintenance,besides,the observation group was given intravenous drip of 1 mL/kg Shenmai Injections during operation,and the control group was given the same amount of 0.9% sodium chloride injections.Serum tumor necrosis factor α(TNF-α) and interleukin 6(IL-6) levels as well as PaO2,PaCO2 and fraction of inspired oxygen(FiO2) were compared between the two groups before anesthesia induction(T0),30 minutes after operation began(T1),at the end of operation(T2),and 24 hours after operation was completed(T3).Results There were statistically significant differences between the two groups in serum TNF-α and IL-6 levels,PaO2,PaCO2 and FiO2(P<0.05),all of the indicators above presented a time-dependent trend in both groups(P<0.05),an interaction was observed between grouping effect and time effect(P<0.05),and the observation group exhibited higher PaO2 at T1,T2 and T3,along with lower PaCO2,FiO2 and serum TNF-α and IL-6 levels,compared with the control group(all P<0.05).Conclusion Shenmai Injections can reduce inflammatory factors levels and improve blood gas analysis indicators in treating sepsis patients undergoing surgery under general anesthesia,having a certain protective effect on lung function.

关 键 词：脓毒症 参麦注射液 炎症因子 肿瘤坏死因子α 白细胞介素6 血气分析 全身麻醉 

分 类 号：R631.4[医药卫生—外科学]