| 周珊珊,蓝海珍,徐 毓,樊又嘉,陈黎雄.右美托咪定联合肺保护性通气策略对肺癌根治术患者氧化应激、炎症反应和免疫功能的影响[J].,2022,(3):454-458 |
| 右美托咪定联合肺保护性通气策略对肺癌根治术患者氧化应激、炎症反应和免疫功能的影响 |
| Effect of Dexmedetomidine Combined with Lung Protective Ventilation Strategy on Oxidative Stress, Inflammatory Response and Immune Function in Patients with Lung Cancer Radical Surgery |
| 投稿时间：2021-08-05 修订日期：2021-08-28 |
| DOI：10.13241/j.cnki.pmb.2022.03.011 |
| 中文关键词: 右美托咪定 肺保护性通气策略 肺癌根治术 氧化应激 炎症反应 免疫功能 |
| 英文关键词: Dexmedetomidine Lung protective ventilation strategy Lung cancer radical surgery Oxidative stress Inflammatory reaction Immune function |
| 基金项目:上海市卫生和计划生育委员会科研项目（201740118） |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定联合肺保护性通气策略对肺癌根治术患者氧化应激、炎症反应和免疫功能的影响。方法：选择我院行肺癌根治术患者110例，入选患者根据信封抽签法分为A组和B组，各为55例。A组接受右美托咪定联合传统通气策略，B组接受右美托咪定联合肺保护性通气策略，观察两组患者的氧合指数（OI）、氧化应激指标[超氧化物歧化酶（SOD）、丙二醛（MDA）]、炎症反应指标[白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]、免疫功能变化以及术后肺部并发症发生率。结果：B组单肺通气前即刻（T2）~恢复双肺通气15 min（T6）时间点OI高于A组（P<0.05）。B组术后72 h（T7）时间点CD3+、CD4+、CD4+/CD8+高于A组，CD8+低于A组（P<0.05）。B组T7时间点SOD水平高于A组，MDA水平低于A组（P<0.05）。B组T7时间点IL-6、TNF-α水平低于A组（P<0.05）。两组术后肺部并发症发生率组间对比无统计学差异（P>0.05）。结论：右美托咪定联合肺保护性通气策略可改善肺癌根治术患者氧合和炎症反应，有效减轻免疫抑制及氧化应激反应。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of dexmedetomidine combined with lung protective ventilation strategy on oxidative stress, inflammatory response and immune function in patients with lung cancer radical surgery. Methods: 110 patients who received lung cancer radical surgery who came to our hospital were selected. The patients were divided into group A and group B according to envelope drawing method, 55 cases in each group. Group A received dexmedetomidine combined with traditional ventilation strategy, group B accepted dexmedetomidine combined with lung protective ventilation strategy, and the oxygenation index (OI), oxidative stress [superoxide dismutase (SOD), malondialdehyde (MDA)], inflammatory response [interleukin-6 (IL-6), tumor necrosis factor-α（TNF-α）], immune function changes and the incidence of postoperative pulmonary complications in two groups were observed. Results: The OI of group B was higher than that of group A at the time point from immediately (T2) before single lung ventilation to 15 min (T6) after resumption of bilateral lung ventilation(P<0.05). CD3+, CD4+, CD4+/CD8+ of group B were higher than those of group A at time point of 72 h after operation (T7), and CD8+ was lower than that of group A(P<0.05). SOD level of group B was higher than that of group A at time point T7, while MDA level of group B was lower than that inofgroup A (P<0.05). The IL-6 and TNF-α levels of group B were lower than those of group A at time point T7 (P<0.05). There was no significant difference in the incidence of postoperative pulmonary complications between the two groups(P>0.05). Conclusion: Dexmedetomidine combined with lung protective ventilation strategy can improve oxygenation and inflammatory response in patients undergoing radical resection of lung cancer, and effectively reduce immunosuppression and oxidative stress. |
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