老年患者术中雾化布地奈德对呼吸功能的影响  

Effect of intraoperative nebulization of budesonide on respiratory function in elderly patients

作　　者：李魁亮[1] 付冬梅[2] 王东昕[2] LI Kuiliang;FU Dongmei;WANG Dongxin(Department of Anesthesiology,Jilin Central Hospital,Jilin 132602,China;Department of Anesthesiology,Jilin Cancer Hospital,Changchun 130000,China)

机构地区：[1]吉林市中心医院麻醉科,吉林吉林132602 [2]吉林省肿瘤医院麻醉科,长春130000

出　　处：《长春中医药大学学报》2024年第6期689-692,共4页Journal of Changchun University of Chinese Medicine

基　　金：吉林市医疗卫生指导性计划项目(20220404010)。

摘　　要：目的探讨老年直肠癌患者腹腔镜手术中,雾化吸入布地奈德对呼吸功能的影响。方法选择112名接受腹腔镜直肠癌手术的患者,按随机数表法分为观察组与对照组,各56例。术前,2组均雾化吸入异丙托溴铵;手术中,观察组联合布地奈德雾化吸入。比较2组麻醉前(T1)、麻醉恢复后10 min(T2)动脉血气指标,以及术前术后第1天血清白细胞介素-6(IL-6)、嗜酸粒细胞阳离子蛋白(ECP)和肺表面活性蛋白D(SP-D)水平。结果T2时刻,2组二氧化碳分压(PaCO_(2))均增加,观察组增加程度显著低于对照组(P<0.05)。观察组T2时刻动脉血氧分压(PaO_(2))比T1时刻提高,对照组下降,且观察组的PaO_(2)在T2时刻显著高于对照组(P<0.05)。观察组血氧饱和度(SaO_(2))在T2时刻比T1时刻显著提高,对照组前后无显著变化,观察组在T1和T2时刻的SaO_(2)均显著高于对照组(P<0.05)。术后第1天,2组血清IL-6水平均较术前下降,观察组下降更为显著。血清ECP和SP-D水平在术后第1天均升高,且观察组水平明显高于对照组(P<0.05)。术后观察组麻醉苏醒时间、拔管时间和麻醉复苏室停留时间均短于对照组(P<0.01)。结论老年直肠癌患者术中雾化吸入布地奈德可以有效改善呼吸功能,减轻炎症反应,提升肺保护因子的水平,缩短麻醉恢复时间。Objective To explore the effect of nebulized budesonide inhalation on respiratory function in elderly patients during laparoscopic rectal cancer surgery.Methods 112 patients who underwent laparoscopic rectal cancer surgery were selected and divided into the observation group and the control group according to random number table method,with 56 cases in each group.Before surgery,both groups inhaled ipratropium bromide through nebulization.During surgery,the observation group additionally inhaled nebulized budesonide.Arterial blood gas indicators before anesthesia(T1)and at 10 minutes after anesthesia recovery(T2)between two groups were compared,and serum levels of interleukin-6(IL-6),eosinophil cationic protein(ECP)and pulmonary surfactant protein D(SP-D)on the first day before and after surgery were also compared.Results At T2,partial pressure of carbon dioxide(PaCO_(2))levels increased in both groups,and the degree of increase in the observation group was significantly lower than that in the control group(P<0.05).In the observation group,partial pressure of oxygen(PaO_(2))levels at T2 were higher than those at T1,while PaO_(2)levels decreased in the control group.And PaO_(2)levels in the observation group were significantly higher than those in the control group at T2(P<0.05).Compared with T1,arterial oxygen saturation(SaO_(2))levels in the observation group significantly increased at T2,while there was no significant change in the control group.SaO_(2)levels in the observation group were significantly higher than those in the control group at T1 and T2(P<0.05).On the first day after surgery,compared with before surgery,the serum IL-6 levels in both groups decreased on average,with the observation group showing the more significant decrease.The levels of serum ECP and SP-D increased on the first day after surgery,and their levels in the observation group were significantly higher than those in the control group(P<0.05).The postoperative anesthesia recovery time,extubation time,and anesthesia recovery room stay t

关 键 词：腹腔镜手术 直肠癌 老年 布地奈德 雾化吸入 呼吸功能 

分 类 号：R735.3[医药卫生—肿瘤]