Department of Cardiovascular Surgery, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
Department of Anaesthesiology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
Biomed Res Int. 2020 Oct 5;2020:4976205. doi: 10.1155/2020/4976205. eCollection 2020.
To investigate the effect of dexmedetomidine on postoperative lung injury in patients undergoing thoracoscopic surgery.
From March 2019 to October 2019, 40 patients were randomly divided into two groups: dexmedetomidine group (group D) and control group (group C). Except recording the general condition of the patients in both groups preoperatively and intraoperatively, the oxygenation index (OI) and alveolar-arterial oxygen partial pressure difference (A-aDO) were monitored at admission (T0), immediately after one-lung ventilation (T1), 0.5 h after one-lung ventilation (T2), and 15 minutes after inhaling air before leaving the room (T3). The content of IL-8 in arterial blood was measured by enzyme-linked immunosorbent assay (ELISA) at T0 and T2, and the expression of AQP1 protein in isolated lung tissue was measured by immunohistochemistry and Western blot. The incidence of postoperative pulmonary complications (atelectasis, pneumonia, and acute respiratory distress syndrome) was used as the index of lung injury.
There was no significant difference in the general condition before and during operation between the two groups. There was no significant difference in arterial blood IL-8 content between the two groups at the T0 time point, but the arterial blood IL-8 content at the T2 time point was significantly higher than that at the T0 time point, especially in group C. The results of immunohistochemistry and Western blot showed that the expression level of AQP1 protein in the isolated lung tissue of group D was significantly higher than that of group C ( < 0 05). At T3, the OI of group D was significantly higher than that of group C, and the A-aDO of group D was significantly lower than that of group C ( < 0.05). There was no significant difference in the incidence of postoperative PPCs between the two groups.
Dexmedetomidine can reduce the level of plasma IL-8 and upregulate the expression of AQP1 in the lung tissue of patients undergoing thoracoscopic surgery under one-lung ventilation, but it has no significant effect on the incidence of postoperative PPCs. Dexmedetomidine can be safely used in thoracoscopic surgery and has a certain protective effect on lung injury.
探讨右美托咪定对胸腔镜手术患者术后肺损伤的影响。
选择 2019 年 3 月至 2019 年 10 月间择期行胸腔镜手术的患者 40 例，随机分为右美托咪定组（D 组）和对照组（C 组）。记录两组患者术前和术中一般情况，于入室时（T0）、单肺通气即刻（T1）、单肺通气 0.5 h（T2）、离开房间前吸入空气 15 min（T3）时监测氧合指数（OI）和肺泡-动脉氧分压差（A-aDO），采用酶联免疫吸附法（ELISA）于 T0、T2 时检测动脉血白细胞介素-8（IL-8）含量，免疫组化法和 Western blot 检测分离肺组织水通道蛋白 1（AQP1）蛋白表达。以术后肺部并发症（肺不张、肺炎和急性呼吸窘迫综合征）发生率作为肺损伤的指标。
两组患者术前、术中一般情况比较，差异无统计学意义。两组患者 T0 时动脉血 IL-8 含量比较，差异无统计学意义，T2 时动脉血 IL-8 含量明显高于 T0 时，C 组升高更明显。免疫组化法和 Western blot 结果显示，D 组分离肺组织 AQP1 蛋白表达水平明显高于 C 组（ < 0.05）。T3 时，D 组 OI 明显高于 C 组，A-aDO 明显低于 C 组（ < 0.05）。两组患者术后 PPCs 发生率比较，差异无统计学意义。
右美托咪定可降低胸腔镜手术单肺通气患者血浆 IL-8 水平，上调肺组织 AQP1 表达，但对术后 PPCs 发生率无明显影响。右美托咪定可安全用于胸腔镜手术，对肺损伤具有一定的保护作用。
