南方医科大学学报 ›› 2024, Vol. 44 ›› Issue (4): 706-711.doi: 10.12122/j.issn.1673-4254.2024.04.12

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红景天注射液降低食管癌根治术患者单肺通气期间肺内分流及血清炎症介质:46例随机对照试验

刘 溪,胡 欢,房 静,黄 璐,程向阳   

  1. 蚌埠医科大学第一附属医院麻醉科,安徽 蚌埠 233000
  • 发布日期:2024-04-29

Effects of Rhodiola rosea injection on intrapulmonary shunt and blood IL-6 and TNF-α levels during single lung ventilation in patients undergoing radical resection of esophageal cancer

LIU Xi, HU Huan, FANG Jing, HUANG Lu, CHENG Xiangyang   

  1. Department of Anesthesiology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China
  • Published:2024-04-29

摘要: 目的 探究红景天对食管癌根治术患者单肺通气期间肺内分流及血炎症介质的影响。方法 选择行择期食管癌根治术患者46例,采取随机数字表法分为生理盐水对照组和红景天组(n=23)。红景天组于患者入室后将10 mL红景天加入250 mL生理盐水或5%葡萄糖注射液缓慢静脉滴注,对照组静滴同等剂量的生理盐水。抽取单肺通气(OLV)开始前(T0)、30 min(T1)、60 min(T2)、恢复双肺通气后30 min(T3)的桡动脉和深静脉血各2 mL,行血气分析,根据公式计算出肺内分流率(Qs/Qt)。分别记录各时间点PaO2。于T0、T1、T3时抽取深静脉血2 mL,检测血清中α-肿瘤坏死因子(TNF-α)、介素6(IL-6)含量,记录术后肺不张情况。结果 与对照组相比,红景天组在T1、T2时,PaO2、Qs/Qt优于对照组(P<0.05),红景天组在T3时IL-6、TNF-α含量降低(P<0.05)。两组患者术后肺不张发生率差异无统计学意义(P>0.05)。结论 红景天可减少食管癌根治术患者单肺通气期间肺内分流,改善氧合,降低患者血清中IL-6、TNF-α含量,减轻患者术中肺损伤。

关键词: 红景天;食管癌;单肺通气;缺氧性肺血管收缩

Abstract: Objective To explore the effects of Rhodiola rosea injection on pulmonary shunt and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels during single lung ventilation in patients undergoing radical resection of esophageal cancer. Methods Forty-six patients undergoing radical operation for esophageal cancer were randomized equally into control group and Rhodiola rosea injection group. In the Rhodiola group, 10 mL of Rhodiola rosea injection was added into 250 mL of normal saline or 5% glucose solution for slow intravenous infusion, and normal saline of the same volume was used in the control group after the patients entered the operation room. At T0, T1 and T3, PaO2 of the patient was recorded and 2 mL of deep venous blood was collected for determination of serum TNF-α and IL-6 levels. The incidence of postoperative atelectasis of the patients was recorded. Results Compared with those in the control group, the patients receiving Rhodiola rosea injection had significantly higher PaO2 and Qs/Qt at T1 and T2 (P<0.05) and lower serum IL-6 and TNF-α levels at T3 (P<0.05). No significant difference in the incidence of postoperative atelectasis was observed between the two groups (P>0.05). Conclusion Rhodiola rosea injection before anesthesia induction can reduce intrapulmonary shunt during single lung ventilation, improve oxygenation, reduce serum IL-6 and TNF-α levels, and alleviate intraoperative lung injury in patients undergoing radical resection of esophageal cancer.

Key words: Rhodiola; esophageal cancer; single lung ventilation; hypoxic pulmonary vasoconstriction