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七氟醚吸入麻醉对老年肺癌患者行肺叶切除术后白细胞介素-6、肿瘤坏死因子-α和基质金属蛋白酶-9表达及血液动力学的影响。

Effects of sevoflurane inhalation anesthesia on IL-6, TNF-α and MMP-9 expression and hemodynamics in elderly patients undergoing lobectomy for lung cancer.

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Fujian Medical University, Fujian, 350005, China.

Department of Anesthesiology, Ningde City Hospital Affiliated to Fujian Medical University, Fujian, 352000, China.

出版信息

Cell Mol Biol (Noisy-le-grand). 2020 Jul 31;66(5):49-53.

Abstract

Objective of current research was to investigate the effect of sevoflurane inhalation anesthesia on hemodynamics and inflammatory response in elderly patients with lung cancer lobectomy. Methods: A total of 168 patients with lung cancer who underwent lobectomy in our hospital from January 2019 to December 2019 were selected as the study subjects. The patients were divided into an observation group and control group according to the anesthesia program. In the control group, 1 mg/kg propofol intravenous pump induced anesthesia was maintained at 6mg/kg/h. In the observation group, 8% sevoflurane was used to induce anesthesia and 2% sevoflurane was used to maintain anesthesia. Mean artery pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were monitored at the beginning of single-lung ventilation (t1), when single-lung ventilation was changed to double-lung ventilation (t2), and at 30 minutes after double-lung ventilation (t3), respectively. Serum levels of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and matrix metalloproteinases (MMP-9) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Assess the patient's adverse reactions. Results: At time t1 and time t2, there was no significant difference in the three hemodynamic indicators between the two groups (P>0.05). However, at t3, both MAP and HR in the observation group were significantly lower than those in the control group, while SpO2 was significantly higher than those in the control group (P<0.05). At t1 and t2, there was no significant difference in IL-6 and TNF- levels between the two groups, but at t3, IL-6 and TNF-α levels in the observation group were significantly lower than those in the control group (P<0.05). Compared with the control group, serum MMP-9 level was significantly decreased in the whole t1 to t3 stage (P<0.05). The incidence of complications in the observation group was significantly higher than that in the control group. It was calculated that Sevoflurane can significantly improve hemodynamics and inflammatory response in elderly patients with lung cancer lobectomy, but the incidence of complications is high.

摘要

目的

研究七氟醚吸入麻醉对老年肺癌肺叶切除术患者血流动力学及炎症反应的影响。

方法

选择我院 2019 年 1 月至 2019 年 12 月收治的肺癌行肺叶切除术患者 168 例作为研究对象。根据麻醉方案将患者分为观察组和对照组,对照组采用 1mg/kg 丙泊酚静脉泵注诱导麻醉,维持剂量为 6mg/kg/h;观察组采用 8%七氟醚诱导麻醉,维持剂量为 2%七氟醚。分别于单肺通气开始时(t1)、单肺通气改为双肺通气时(t2)、双肺通气 30min 时(t3)监测平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2),采用酶联免疫吸附试验(ELISA)试剂盒检测血清白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、基质金属蛋白酶(MMP-9)水平,评估患者不良反应发生情况。

结果

t1、t2 时两组患者的 3 项血流动力学指标比较差异均无统计学意义(P>0.05);t3 时观察组的 MAP、HR 均显著低于对照组,SpO2 显著高于对照组(P<0.05)。t1、t2 时两组患者的 IL-6、TNF-α 水平比较差异均无统计学意义,t3 时观察组的 IL-6、TNF-α 水平显著低于对照组(P<0.05)。与对照组比较,观察组在 t1 至 t3 整个阶段的血清 MMP-9 水平显著降低(P<0.05)。观察组的并发症发生率显著高于对照组。

结论

七氟醚可明显改善老年肺癌肺叶切除术患者的血流动力学及炎症反应,但并发症发生率较高。

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