七氟醚对心脏瓣膜置换术患者氧化应激及肺损伤的影响研究  

Effects of Sevoflurane on Oxidative Stress and Lung Injury in Patients Undergoing Cardiac Valve Replacement

作　　者：王海振 柯少凡[1] 贾佳 刘洋[1] WANGHaizhen;KE Shaofan;JIA Jia;LIU Yang(The First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院,福建厦门361000

出　　处：《中外医学研究》2022年第29期110-115,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨七氟醚对心脏瓣膜置换术患者氧化应激及肺损伤的影响。方法:选取2018年10月-2020年12月厦门大学附属第一医院心脏外科临床收治的心脏瓣膜置换术患者88例为研究对象,按随机数字表法将患者分为研究组和对照组,每组44例。对照组给予常规麻醉,研究组在对照组基础上给予七氟醚吸入。对两组不同时点的炎症因子指标、血流动力学指标、氧化应激指标和血气指标进行观察和比较。结果:复温至36℃时(T_(2))、体外循环(CPB)停机1 h(T_(3))、术毕(T_(4))及术后24 h(T_(5))时,研究组的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)等各项炎症因子指标均低于对照组,差异均有统计学意义(P<0.05);切皮时(T_(1))、劈胸骨时(T_(2))、CPB后10 min(T_(3))、复温至36℃时(T_(4))、CPB停机1 h(T_(5))、术毕(T_(6))时,研究组的平均动脉压(MAP)和中心静脉压(CVP)均高于对照组,差异均有统计学意义(P<0.05);切皮时(T_(1))、劈胸骨时(T_(2))、CPB后10 min(T_(3))时,研究组的心率(HR)低于对照组,差异有统计学意义(P<0.05);主动脉阻断即刻(T_(1))、主动脉开放即刻(T_(2))、主动脉开放后30 min(T_(3))、主动脉开放后6 h(T_(4))、主动脉开放后12 h(T_(5))时,研究组的超氧化物歧化酶(SOD)高于对照组,丙二醛(MDA)低于对照组,差异有统计学意义(P<0.05);主动脉开放后30 min(T_(3))时,研究组的谷胱甘肽过氧化物酶(GSH-Px)高于对照组,差异有统计学意义(P<0.05);体外循环前两组的血气指标比较,差异无统计学意义(P>0.05),体外循环后2 h研究组的动脉氧分压(PaO_(2))指标高于对照组,且差异有统计学意义(P<0.05)。结论:七氟醚能够有效抑制心脏瓣膜置换术患者体内的氧化应激和炎症反应过程,保护患者的肺功能,减少肺损伤。Objective:To investigate the effects of Sevoflurane on oxidative stress and lung injury in patients undergoing cardiac valve replacement.Method:A total of 88 patients with cardiac valve replacement who were admitted tothe Department of Cardiac Surgery,the First Affiliated Hospital of Xiamen University from October 2018 to December 2020 were selected as the research objects.The patients were divided into the study group and the control group according to the random number table method,with 44 cases in each group.The control group was given routine anesthesia,and the study group was given Sevoflurane inhalation on the basis of the control group.The indexes of inflammatory factors,hemodynamics,oxidative stress and blood gas at different time points were observed and compared between the two groups.Result:When rewarming to 36℃(T_(2)),cardiopulmonary bypass(CPB)was stopped for 1 hour(T_(3)),and after operation(T_(4))and 24 hours(T_(5)),the indexes of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).At skin cutting(T_(1)),sternum splitting(T_(2)),10 minutes after CPB(T_(3)),rewarming to 36℃(T_(4)),CPB shutdown for 1 hour(T_(5)),and operation completion(T6),the the mean arterial pressure(MAP)and central venous pressure(CVP)in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).At skin cutting(T_(1)),sternal splitting(T_(2)),10 minutes after CPB(T_(3)),the heart rate(HR)in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).At immediately after aortic occlusion(T_(1)),immediately after aortic opening(T_(2)),30 minutes after aortic opening(T_(3)),6 hours after aortic opening(T_(4)),12 hours after aortic opening(T_(5)),the superoxide dismutase(SOD)in the study group were higher than those in the control group,the malond

关 键 词：七氟醚 心脏瓣膜置换术 氧化应激 肺损伤 

分 类 号：R614[医药卫生—麻醉学]