七氟醚对肺癌患者围术期TNFα影响.docVIP

七氟醚对肺癌患者围术期TNF-α的影响 　　[摘要] 目的:观察七氟醚对肺癌患者围术期血清中肿瘤坏死因子α(TNF-α)的影响。方法:选择30例Ⅰ～Ⅱ期肺癌择期行左侧开胸肺叶切除手术患者,ASAⅠ～Ⅱ级,随机分为芬太尼组(C组)和七氟醚组(S组)。分别于麻醉诱导前1 min(T1),单肺通气40 min(T2)、90 min(T3)和120 min(T4)时取外周静脉血样测TNF-α浓度。结果:单肺通气后两组TNF-α水平均较单肺通气前显著升高(P0.05)。单肺通气(OLV)后T3、T4时刻TNF-α水平 C组显著高于S组(P0.05)。结论:七氟醚可降低肺癌患者血清TNF-α的浓度,减轻围术期的全身炎症反应。 　　[关键词] 七氟醚;肺癌;肿瘤坏死因子;全身炎症反应 　　[中图分类号] R614.2[文献标识码]A [文章编号]1673-7210(2010)04(b)-045-02 　　 　　Effect of sevoflurane on the serum concentration of TNF-α during the periperative period in lung carcinoma patients 　　LIU Jun1, DONG Youjing2 　　(1.Weikang Hospital of Shenyang City, Shenyang 110020, China; 2.Department of Anesthesia, Shengjing Hospital of China Medical University, Shenyang 110004, China) 　　[Abstract] Objective: To study the effect of sevoflurane on the alternation of serum concentration of TNF-α during the periperative period in patients undergoing pulmonary lobectomy of left-thoracis surgery. Methods: 30 cases of Ⅰ-Ⅱ lung carcinoma patients, ASAⅠ-Ⅱ, scheduled for elective pulmonary lobectomy of left-thoracis surgery were divided into fentanyl groups (C) and sevoflurane groups (S). The peripheral vein blood samples were collected 1 minute before anesthesia induction 60, 90, 120 minutes after one-lung ventilation (OLV) for the detection of TNF-α. Results: The concentration of TNF-α was significantly increaded after OLV than that before OLV in two groups (P0.05); the concentration of TNF-α was significantly increaded in groups C than that in group S after OLV (P0.05). Conclusion: During the periperative period, sevoflurane could reduce the serum concentration of TNF-α in lung carcinoma patients, result in alleviation of systemic inflammatory response. 　　[Key words] Sevoflurane; Lung cancer; Tumor necrosis factor-α; Systemic inflammatory response 　　 　　肿瘤坏死因子α(TNF-α)作为早期炎症因子,在肺脏炎性反应中起着重要作用。研究表明,肺癌患者血清中TNF-α水平较正常人明显增高,且随分期的发展,含量越升高,且麻醉手术中多种因素均可使血中TNF-α浓度进一步升高,直接威胁手术患者的生命安全。因此,预防它的发生对麻醉医生具有重要的意义。大量实验证明,吸人麻醉药有肺脏保护作用,但是否七氟醚对肺癌患者围术期TNF-α的浓度有抑制作用,尚未明确