单肺通气时程对老年开胸手术患者肿瘤坏死因子α白细胞介素8影响.docVIP

单肺通气时程对老年开胸手术患者肿瘤坏死因子α白细胞介素8影响 　　[摘要] 目的 研究单肺通气时程对老年开胸手术患者肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）的影响。 方法 选择建德市第一人民医院2011年1月～2013年12月收治的单肺通气开胸手术的老年患者153例，按照单肺通气时程将患者分为1组（3 h），每组各51例。观察指标：各组患者在麻醉前（T1）、麻醉后（T2）以及手术结束前（T3）和术后1 d（T4）的心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）以及T2～T3时肺泡灌洗液中TNF-α和IL-8变化情况。 结果 ①各组间同时间点HR、MAP、CVP比较，差异无统计学意义（P 0.05）。同组内不同时点MAP、CVP差异有统计学意义（P 0.05）；但在T3时点，2组萎陷肺TNF-α、1～3组萎陷肺IL-8值均高于比同组通气肺，差异有统计学意义（P 0.05）。 结论 不同单肺通气时程对老年患者术中、术后24 h的血流动力学无显著影响，但肺泡灌洗液TNF-α和IL-8浓度随着单肺通气时间延长而增加，单肺通气超过3 h最显著且萎陷侧肺比通气侧肺更加明显。 　　[关键词] 单肺通气；肿瘤坏死因子-α；白细胞介素-8 　　[中图分类号] R655[文献标识码] A[文章编号] 1673-7210（2014）06（c）-0078-06 　　 　　Effect of one-lung ventilation duration on tumor necrosis factor-α, interleukin-8 in elderly patients with open thoracic surgery 　　WANG Sanyue1 CHENG Yuan2 　　1.Department of Anesthesiology, Jiande Branch of the Second Affiliated Hospital, School of Medicine, Zhejiang Universitythe First Peoples Hospital of Jiande City, Zhejiang Province, Jiande 311600, China; 2.Department of Anesthesiology, the First Peoples Hospital of Hangzhou City, Zhejiang Province, Hangzhou 310006, China 　　[Abstract] Objective To investigate the influence of one-lung ventilation on TNF-α, IL-8 in elderly patients with open thoracic surgery. Methods 153 patients with one-lung ventilation in thoracic operation in the First Peoples Hospital of Jiande City from January 2011 to December 2013 were selected and divided into 1th group (3 h) according to the duration of the one-lung ventilation with 51 cases in each group. The HR, MAP, CVP, TNF-α and IL-8 were recorded and compared before anesthesia (T1), after anesthesia (T2), before the end of surgery (T3) and 24 h after surgery (T4). Results ①The differences of HR, MAP, CVP among each group were not statistically significant (P 0.05). The differences of MAP, CVP in the same group at different time were statistically significant (P 0.05). ②The TNF-α, IL-8 level of atelectatic lung and ventilation lung in 1th-3rd group at the T3 time point were all high