摘要
目的 分析氟比洛芬酯与丙泊酚复合麻醉对老年肺癌肺叶切除术患者围术期肺氧合功能、血流动力学及呼吸顺应性的影响.方法 选取2020 年1 月—2022 年6 月行肺叶切除术的老年肺癌100 例为研究对象,根据围术期麻醉方式的不同分为观察组和对照组,每组50 例.观察组在单肺通气前实施氟比洛芬酯与丙泊酚复合麻醉,对照组在单肺通气前实施丙泊酚全凭静脉麻醉.比较 2 组术中丙泊酚用量,不同时间点[麻醉诱导前(T1)、单肺通气30 min(T2)、单肺通气60 min(T3)及术毕(T4)]肺氧合功能指标[氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(OI)]、血流动力学指标[平均动脉压(MAP)、心率(HR)]及呼吸顺应性指标[动态肺顺应性(Cdyn)]的变化情况,以及术后并发症发生情况.结果 观察组术中丙泊酚用量(110.32±3.89)mg明显少于对照组(168.21±4.86)mg(P＜0.01).T1 和T4 时,2 组PaO2、PaCO2、OI、MAP、HR、Cdyn比较差异均无统计学意义(P＞0.05);与T1 时比较,2 组在T2 和T3 时PaO2、PaCO2、OI、HR及Cdyn均明显降低,MAP明显升高(P＜0.05);其中观察组T2 和T3 时PaO2、OI及Cdyn高于对照组,MAP、HR明显低于对照组(P＜0.05,P＜0.01).观察组术后并发症总发生率 18.00%(9/50)低于对照组54.00%(27/50)(P＜0.01).结论 对行单肺通气下肺癌肺叶切除术的老年患者应用氟比洛芬酯与丙泊酚复合麻醉效果确切,可明显减少术中丙泊酚用量,改善患者围术期肺氧合功能及血流动力学,提高患者呼吸顺应性,有效保护肺功能,且安全性较好.
Abstract
Objective To analyze the effects of combined anesthesia with Flurbiprofen Axetil and Propofol on periop-erative pulmonary oxygenation function,hemodynamics and respiratory compliance in elderly patients with lung cancer under-going lobectomy.Methods A total of 100 elderly patients who underwent pulmonary lobectomy for lung cancer from January 2020 to June 2022 were selected as the research subjects and divided into observation group(n =50)and control group(n = 50)according to different perioperative anesthesia methods.The observation group was given combined anesthesia with Flurbi-profen Axetil and Propofol before single lung ventilation,and the control group was given intravenous anesthesia of Propofol be-fore single lung ventilation.The intraoperative dosage of Propofol was observed and compared between the two groups.Pulmo-nary oxygenation function indexes[partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),oxygena-tion index(OI)],hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR)]and respiratory compliance in-dexes[dynamic pulmonary compliance(Cdyn)]at different time points[before induction of anesthesia(T1),at 30 min after single lung ventilation(T2),at 60 min after single lung ventilation(T3)and immediately after operation(T4)],and the oc-currence of postoperative complications were compared between the two groups.Results Intraoperative dosage of Propofol in the observation group was(110.32±3.89)mg,which was significantly lower than that in the control group[(168.21±4.86)mg](P＜0.01).At T1 and T4,there were no significant differences in PaO2,PaCO2,OI,MAP,HR and Cdyn be-tween the two groups(P＞0.05).Compared with those at T1,PaO2,PaCO2,OI,HR and Cdyn in the two groups were sig-nificantly decreased at T2 and T3,while MAP was significantly increased(P＜0.05).At T2 and T3,PaO2,OI and Cdyn in the observation group were higher than those in the control group,while MAP and HR were significantly lower than those in the control group(P＜0.05,P＜0.01).The total incidence of postoperative complications in the observation group[18.00%(9/50)]was lower than that in the control group[54.00%(27/50)](P＜0.01).Conclusion Flurbiprofen Axetil com-bined with Propofol has a definite anesthetic effect on elderly lung cancer patients undergoing pulmonary lobectomy under sin-gle lung ventilation,which can significantly reduce intraoperative dosage of Propofol,improve perioperative pulmonary oxygen-ation function and hemodynamics,improve respiratory compliance,effectively protect lung function,and have good safety.
基金项目
北京市住院医师规范化培训质量提高项目(住培2023028)
维普
万方数据