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纸质出版:2014
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查兴盛,陈林,陈杨,张喆.奥曲肽对肝叶切除术患者围术期肺功能及炎性介质的影响[J].陆军军医大学学报(原第三军医大学学报),2014,36(05):503-506.
Zha Xingsheng,Chen Lin,Chen Yang,Zhang Zhe.Effects of octreotide on peri-operative pulmonary function and inflammatory response in patients undergoing hepatic lobectomy[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(05):503-506.
查兴盛,陈林,陈杨,张喆.奥曲肽对肝叶切除术患者围术期肺功能及炎性介质的影响[J].陆军军医大学学报(原第三军医大学学报),2014,36(05):503-506. DOI:
Zha Xingsheng,Chen Lin,Chen Yang,Zhang Zhe.Effects of octreotide on peri-operative pulmonary function and inflammatory response in patients undergoing hepatic lobectomy[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(05):503-506. DOI:
目的 观察奥曲肽对肝叶切除术患者围术期血浆肿瘤坏死因子-α(tumour necrosis factor alpha,TNF-α)、白细胞介素-6(interleukin 6,IL-6)、肺表面活性物质相关蛋白D(surfactant protein D,SP-D)、氧合指数(oxygenation index,OI)和呼吸指数 (respiratory index,RI)的影响,探讨奥曲肽对肝癌患者肝叶切除术围术期肺损伤的保护效应及可能机制。 方法 选择2013年2-12月于西南医院肝胆外科择期行肝叶切除术的肝癌患者40例,ASAⅡ~Ⅲ级,随机分为对照组或奥曲肽组,每组20例。2组患者均采用相同的麻醉方法。奥曲肽组在麻醉诱导后静脉注射奥曲肽0.1 mg,然后0.5 mg溶于60 mL氯化钠注射液中泵注至手术结束前30 min停止;对照组予等容量氯化钠注射液泵注。监测并对比分析麻醉诱导前(T
0
)、切皮后10 min (T
1
)、解除阻断恢复肝血流后30 min (T
2
)、术后1 h(T
3
)、术后24 h(T
4
)桡动脉血血气分析结果
计算OI值和RI值; 于T
0
、T
1
、T
2
、T
4
时检测TNF-α、IL-6和SP-D浓度。 结果 两组组内各时相点与麻醉诱导前(T
0
)相比,T
2
~T
4
时两组TNF-α、IL-6、SP-D的含量和RI值均显著升高(
P
0.05);而OI值显著降低 (
P
0.05)。两组组间各时相点同时值比较,T
2
~T
4
三个时相点奥曲肽组TNF-α、IL-6、SP-D的含量和RI值均低于对照组,而OI值高于对照组,差异均有统计学意义(
P
0.05)。 结论 奥曲肽能够抑制肝叶切除术患者围术期炎性反应,减轻肺损伤,并由此降低手术对肺功能的影响。
Objective To investigate the effects of octreotide on tumour necrosis factor alpha (TNF-α)
interleukin 6 (IL-6)
sur
factant protein D (SP-D)
oxygenation index (OI) and respiratory index (RI) in patients during peri-operative period of hepatic lobectomy. Methods Forty ASA Ⅱ or Ⅲ patients scheduled for hepatic lobectomy in Southwest hospital from February to December 2013 were enrolled in this study. Then they were randomly divided into octreotide group and control (n=20). The same standard anesthesia protocol was used for induction and maintenance in all 2 groups. After anesthesia induction
the octreotide group was given 0.1 mg octreotide intravenously followed by 0.5 mg/60 mL by pain pump until the end of the surgery. While the patients of control were given same volume of normal saline through same approach. Arterial blood samples were collected for blood gas analysis before induction of anesthesia (T
0
)
10 min after cutting skin (T
1
)
30 min after recuperating liver blood flow (T
2
)
and l (T
3
) and 24 h (T
4
) after operation. OI and RI were calculated. Plasma TNF-α
IL-6 and SP-D were measured at T
0
T
1
T
2
T
3
and T
4
. Results Compared with T
0
the plasma levels of TNF-α
IL-6 and SP-D and RI were significantly increased
while the OI was significantly decreased at T
2
to T
4
in the 2 groups (
P
0.05). The plasma level of TNF-α
IL-6 and SP-D and RI in the octreotide group were significantly lower
while the OI was obviously higher than those in the control group at T
2
to T
4
(
P
0.05). Conclusion Octreotide attenuates the lung injury and protects lung function induced by hepatic lobectomy
which probably through inhibiting inflammatory response.
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