Cheng Yuan-Da, Gao Yang, Zhang Heng, Duan Chao-Jun, Zhang Chun-Fang
Department of Cardiothoracic Surgery of Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
Medical Science Institute of Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
Asian J Surg. 2014 Apr;37(2):80-5. doi: 10.1016/j.asjsur.2013.09.003. Epub 2013 Dec 5.
To observe the effects of intermittent one-lung ventilation (OLV) before and after surgery on the inflammatory cytokines and biomarkers of oxidative stress in serum of lung cancer patients undergoing open thoracotomy.
Between June 2011 to March 2012, 80 patients undergoing lobectomy were classified into four groups nonrandomly: Group A, control group; B, OLV preconditioning group; C, OLV postconditioning group; D, OLV preconditioning-combined-with-postconditioning group. Neutrophil granulocyte (PMN), interleukin 6 (IL-6), superoxide dismutase (SOD), and malondialdehyde (MDA) were assayed in plasma samples taken preoperatively (T1), intraoperatively (T2), and 2 hours postoperatively (T3).
Comparison of T1 with T2 and T3 documented significant increase in MDA, PMN, and IL-6 levels and decrease in SOD in the control group (p < 0.01). Compared with the control group, the levels of IL-6 and MDA decreased and SOD increased significantly at T2 in the OLV preconditioning group, at T3 in the OLV preconditioning combined postconditioning group (p < 0.05).
Preconditioning of intermittent OLV before thoracotomy combined with postconditioning of intermittent returning two-lung ventilation after surgery maybe alleviate systematic inflammatory response and oxidative stress for lung cancer patients.
观察开胸肺癌手术患者术前、术后间歇性单肺通气（OLV）对血清中炎性细胞因子及氧化应激生物标志物的影响。
2011年6月至2012年3月期间，80例行肺叶切除术的患者非随机分为四组：A组为对照组；B组为OLV预处理组；C组为OLV后处理组；D组为OLV预处理联合后处理组。于术前（T1）、术中（T2）及术后2小时（T3）采集血浆样本，检测中性粒细胞（PMN）、白细胞介素6（IL-6）、超氧化物歧化酶（SOD）及丙二醛（MDA）。
对照组T1与T2、T3比较，MDA、PMN及IL-6水平显著升高，SOD降低（p<0.01）。与对照组相比，OLV预处理组T2时IL-6及MDA水平降低，SOD显著升高；OLV预处理联合后处理组T3时IL-6及MDA水平降低，SOD显著升高（p<0.05）。
开胸术前间歇性OLV预处理联合术后间歇性双肺通气后处理可能减轻肺癌患者的全身炎症反应及氧化应激。
