依达拉奉在全麻下行胸腔镜下食管癌根治术患者中的应用效果

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摘要目的探讨依达拉奉在全麻胸腔镜下食管癌根治术患者中的应用效果。方法选取2016年12月～2017年8月于青岛市立医院行全麻胸腔镜下食管癌根治术的60 例患者作为研究对象，年龄35～68 岁，美国麻醉医师协会（ASA）Ⅰ～Ⅱ级。采用随机数字表法将其分为EI 和CG 组，每组各30 例。EI 组患者麻醉诱导后将依达拉奉30 mg加入0.9%氯化钠100 ml 中静滴，CG 组患者麻醉诱导后给予等量0.9%氯化钠静滴。分别于麻醉后切皮前（T0）、单肺通气60 min（T1）、单肺通气90 min（T2）、单肺通气120 min（T3）、膨肺30 min（T4）及术后60 min（T5）采取静脉血，采用酶联免疫吸附法（ELISA）检测磷脂酰肌醇-3 激酶（PI3K）、磷酸化蛋白激酶B（p-AKT）、活化蛋白-1（AP-1）、白介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）和超氧化物歧化酶（SOD）表达水平，并比较两组患者的手术情况。结果两组患者的手术时间、术中单肺通气时间、麻醉时间、手术径路、麻醉后监测治疗室（PACU）时间比较，差异无统计学意义（P＞0.05）。两组患者T1～T5 时血浆中的PI3K、p-AKT、AP-1、IL-8 及TNF-α 表达水平均高于T0，差异有统计学意义（P＜0.05）；两组患者T1～T5 时血浆中的SOD 表达水平低于T0 时，差异有统计学意义（P＜0.05）；EI 组患者T1～T5 时血浆中的PI3K、p-AKT、AP-1、IL-8 及TNF-α 表达水平均低于CG 组，差异有统计学意义（P＜0.05）；EI组患者T1～T5 时血浆中的SOD 表达水平高于CG 组，差异有统计学意义（P＜0.05）。结论依达拉奉对单肺通气性肺损伤有保护作用，通过减少促炎性细胞因子的释放，减少术后肺炎性反应。

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	艾登斌

关键词 ：依达拉奉, 单肺通气, 肺损伤

Abstract：Objective To investigate the application effect of Edaravone in patients undergoing thoracoscopic esophagectomy under general anesthesia.Methods A total of 60 patients undergoing thoracoscopic esophagectomy under general anesthesia in Qingdao Municipal Hospital from December 2016 to August 2017 were selected as the research subjects, aged 35-68 years old, with American Society of Anesthesiologists (ASA) Ⅰ-Ⅱgrades.All patients were divided into EI group and CG group according to the random number table method, 30 cases in each group.Patients in the EI group were given intravenous infusion of Edaravone 30 mg in 0.9% sodium chloride 100 ml after induction of anesthesia, while those in the CG group were given intravenous infusion of equal amounts of sodium chloride after induction of anesthesia.The venous blood samples were obtained at the following time points respectively：before skin incision after anesthesia (T0), one lung ventilation 60 min (T1), one lung ventilation 90 min (T2), one lung ventilation 120 min (T3), dilated lung 30 min (T4) and 60 min after operation (T5), and enzyme-linked immunosorbent assay(ELISA) was used to detect phosphatidyl inositol 3-kinase (PI3K), phosphorylated protein kinase B (p-AKT), activating protein-1 (AP-1), and interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and superoxide dismutase (SOD) expression levels.The operation of the two groups of patients was compared.Results There were no significant differences in the operation time, intraoperative one lung ventilation time, anesthesia time, operation path, and post-anesthesia care unit (PACU) time between the two groups (P＞0.05).The expression levels of PI3K, p-AKT, AP-1, IL-8 and TNF-α in the plasma of the two groups at T1-T5 were higher than those at T0, and the differences were statistically significant (P＜0.05).The expression levels of SOD in the plasma of the two groups at T1-T5 were lower than those at T0, and the differences were statistically significant (P＜0.05).The expression levels of PI3K, p-AKT, AP-1, IL-8 and TNF-α in the plasma of patients in EI group at T1-T5 were lower than those in CG group, and the differences were statistically significant (P＜0.05).The expression levels of SOD in the plasma of patients in EI group at T1-T5 were higher than those in CG group, and the differences were statistically significant (P＜0.05).Conclusion Edaravone has a protective effect on one lung ventilation-induced lung injury, and reduces the postoperative pulmonary inflammatory response by reducing the release of pro-inflammatory cytokines.

Key words： Edaravone One lung ventilation Lung injury

基金资助:山东省青岛市市立医院“总院长新技术、新项目创新研究基金”项目（Ⅷ院ZYZJJ2017028）

引用本文:

唐玉茹; 帅训军; 徐堂文; 李会; 孙常荣; 艾登斌. 依达拉奉在全麻下行胸腔镜下食管癌根治术患者中的应用效果[J]. 中国当代医药, 2020, 27(13): 107-110.
TANG Yu-ru; SHUAI Xun-jun; XU Tang-wen; LI Hui; SUN Chang-rong; AI Deng-bin. Application effect of Edaravone in patients undergoing thoracoscopic esophagectomy under general anesthesia. 中国当代医药, 2020, 27(13): 107-110.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I13/107

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