氟比洛芬酯与丙泊酚复合麻醉对老年肺癌肺叶切除术患者肺氧合功能、血流动力学及呼吸顺应性的影响  

Effects of Combined Anesthesia with Flurbiprofen Axetil and Propofol on Pulmonary Oxygenation Function,Hemodynamics and Respiratory Compliance in Elderly Patients with Lung Cancer Undergoing Lobectomy

作　　者：包萌萌 吴安石[1] BAO Mengmeng;WU Anshi(Department of Anesthesiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院麻醉科,北京100020

出　　处：《临床误诊误治》2024年第1期99-104,共6页Clinical Misdiagnosis & Mistherapy

基　　金：北京市住院医师规范化培训质量提高项目(住培2023028)。

摘　　要：目的分析氟比洛芬酯与丙泊酚复合麻醉对老年肺癌肺叶切除术患者围术期肺氧合功能、血流动力学及呼吸顺应性的影响。方法选取2020年1月—2022年6月行肺叶切除术的老年肺癌100例为研究对象,根据围术期麻醉方式的不同分为观察组和对照组,每组50例。观察组在单肺通气前实施氟比洛芬酯与丙泊酚复合麻醉,对照组在单肺通气前实施丙泊酚全凭静脉麻醉。比较2组术中丙泊酚用量,不同时间点[麻醉诱导前(T1)、单肺通气30 min(T2)、单肺通气60 min(T3)及术毕(T4)]肺氧合功能指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(OI)]、血流动力学指标[平均动脉压(MAP)、心率(HR)]及呼吸顺应性指标[动态肺顺应性(Cdyn)]的变化情况,以及术后并发症发生情况。结果观察组术中丙泊酚用量(110.32±3.89)mg明显少于对照组(168.21±4.86)mg(P<0.01)。T1和T4时,2组PaO_(2)、PaCO_(2)、OI、MAP、HR、Cdyn比较差异均无统计学意义(P>0.05);与T1时比较,2组在T2和T3时PaO_(2)、PaCO_(2)、OI、HR及Cdyn均明显降低,MAP明显升高(P<0.05);其中观察组T2和T3时PaO_(2)、OI及Cdyn高于对照组,MAP、HR明显低于对照组(P<0.05,P<0.01)。观察组术后并发症总发生率18.00%(9/50)低于对照组54.00%(27/50)(P<0.01)。结论对行单肺通气下肺癌肺叶切除术的老年患者应用氟比洛芬酯与丙泊酚复合麻醉效果确切,可明显减少术中丙泊酚用量,改善患者围术期肺氧合功能及血流动力学,提高患者呼吸顺应性,有效保护肺功能,且安全性较好。Objective To analyze the effects of combined anesthesia with Flurbiprofen Axetil and Propofol on perioperative pulmonary oxygenation function,hemodynamics and respiratory compliance in elderly patients with lung cancer undergoing lobectomy.Methods A total of 100 elderly patients who underwent pulmonary lobectomy for lung cancer from January 2020 to June 2022 were selected as the research subjects and divided into observation group(n=50)and control group(n=50)according to different perioperative anesthesia methods.The observation group was given combined anesthesia with Flurbiprofen Axetil and Propofol before single lung ventilation,and the control group was given intravenous anesthesia of Propofol before single lung ventilation.The intraoperative dosage of Propofol was observed and compared between the two groups.Pulmonary oxygenation function indexes[partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI)],hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR)]and respiratory compliance indexes[dynamic pulmonary compliance(Cdyn)]at different time points[before induction of anesthesia(T1),at 30 min after single lung ventilation(T2),at 60 min after single lung ventilation(T3)and immediately after operation(T4)],and the occurrence of postoperative complications were compared between the two groups.Results Intraoperative dosage of Propofol in the observation group was(110.32±3.89)mg,which was significantly lower than that in the control group[(168.21±4.86)mg](P<0.01).At T1 and T4,there were no significant differences in PaO_(2),PaCO_(2),OI,MAP,HR and Cdyn between the two groups(P>0.05).Compared with those at T1,PaO_(2),PaCO_(2),OI,HR and Cdyn in the two groups were significantly decreased at T2 and T3,while MAP was significantly increased(P<0.05).At T2 and T3,PaO_(2),OI and Cdyn in the observation group were higher than those in the control group,while MAP and HR were significantly lower than those in the control group(P<0.05,P<0.01).The total incidence of pos

关 键 词：肺肿瘤 老年人 肺叶切除术 麻醉 氟比洛芬酯 丙泊酚 氧合指数 血流动力学 呼吸顺应性 并发症 

分 类 号：R614.1[医药卫生—麻醉学] R734.2[医药卫生—外科学]