目的 观察在肺癌根治术中不同潮气量(VT)的单肺通气(OLV)对血IL-6、IL-8表达的影响.方法 30例行肺癌根治术患者,用随机数字表法分为3组.行双腔支气管插管麻醉,术中单肺通气期间在保持分钟通气量不变的情况下,A组VT=10 ml/kg,呼吸频率(f)=12次/min,B组VT=8 ml/kg,f=15次/min,C组VT=6 ml/kg,f=20次/min.在OLV前(T1)、OLV后30 min(T2)、60 min(T3)、OLV结束前(T4)检测血IL-6、IL-8的表达.结果 3组在T2、T3、T4时点的IL-6、IL-8表达均明显高于T1(P＜0.05),且随OLV时间延长而逐渐升高;OLV后随设定的潮气量减低,IL-6及IL-8表达逐渐降低; A组的IL-6、IL-8表达显著高于B、C组(P＜0.05).结论 在单肺通气的肺癌根治术中,采用小潮气量的通气模式可减少肺内炎症反应.%Objective To study effect of one-lung ventilation( OLV ) of different tidal volume( VT ) on the expressions of serum interleukin-6( IL-6 ) and interleukin-8( IL-8 ) in lung cancer patients during radical operation. Methods Thirty lung cancer patients undergoing radical operation were enrolled in the study. All the patients received double-lumen endobronchial intubation anesthesia, and were randomly divided into three groups after one-lung ventilation during radical operation: Group A( VT = 10 ml/kg, respiratory frequency( f ) = 12/min ), Group B( VT = 8 ml/kg, f = 12/min ), Group C( VT =6 ml/kg,f = 12/min ). The expressions of serum IL-6,IL-8 were detected before OLV( T1 ),30 min after OLV ( T2 ),60 min after OLV ( T3 ),1 min before OLV ending( T4 ). Results Compared with T1 ,the expressions of IL-6,IL-8 on T2 ,T3 ,T4 significantly increased in three groups( P <0. 05 ),and the increase was in a time-dependent manner. The expressions of IL-6, IL-8 gradually decreased with VT reduction during OLV. The expressions of IL-6, IL-8 in Group A were significantly higher than those in Group B, C( P < 0. 05 ). Conclusion The ventilation mode of low tidal volume can reduce the pulmonary inflammatory response in radical operation for lung cancer with one-lung ventilation.
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