摘要
Abstract
Objective:To explore the effects of Dexmedetomidine combined with one-lung ventilation protection strategy on immune function and lung injury in patients with pulmonary lobectomy.Method:A total of 100 patients with lung cancer who underwent lung lobectomy in Jiangxi Provincial Chest Hospital from January 2020 to December 2022 were enrolled in the study and were randomly divided into control group and observation group,with 50 cases in each group.Both groups were treated with one-lung ventilation protection strategy,and the observation group was additionally given Dexmedetomidine on this basis.The operative conditions,mean arterial pressure(MAP),heart rate(HR),oxidative stress index and serum inflammation index were determined 10 min before anesthesia induction(T0),10 min after single lung ventilation(T1),1 h after single lung ventilation(T2)and after operation(T3),ischemia-reperfusion injury indicators and immune function indicators were compared between the two groups.Result:There were no significant differences in operation time,single lung ventilation time,intraoperative infusion volume,intraoperative blood loss and recovery time between the two groups(P>0.05).The MAP and HR at T1,T2 and T3 in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The levels of serum superoxide dismutase(SOD)at T1,T2 and T3 in observation group were higher than those in control group,while the levels of serum malondialdehyde(MDA)were lower than those in control group,the differences were statistically significant(P<0.05).The levels of serum interferon-γ(IFN-γ)and interleukin-10(IL-10)at T2 and T3 in observation group were lower than those in control group,the differences were statistically significant(P<0.05).Serum levels of vascular endothelial growth factor(VEGF)and hypoxia-inducing factor-1α(HIF-1α)at T3 in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The levels of CD3+,CD4+ and CD4+/CD8+ at T3 in observation group were higher than those in control group,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with one-lung ventilation protection strategy is beneficial to maintaining the stability of intraoperative hemodynamics,and it can reduce the oxidative stress response and inflammatory response,and alleviate the ischemia-reperfusion injury caused by one-lung ventilation,and it has small influence on immune function.关键词
肺叶切除术/单肺通气/保护策略/右美托咪定/肺损伤/免疫功能Key words
Pulmonary lobectomy/One-lung ventilation/Protection strategy/Dexmedetomidine/Lung injury/Immune function
