Effect of Dexmedetomidine on Postoperative Lung Injury during One-Lung Ventilation in Thoracoscopic Surgery.
Effect of Dexmedetomidine on Postoperative Lung Injury during One-Lung Ventilation in Thoracoscopic Surgery.
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右美托咪定对胸腔镜手术单肺通气术后肺损伤的影响
DOI：
10.1155/2020/4976205
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发表时间：
2020
影响因子：
--
通讯作者：
Yang K
中科院分区：
文献类型：
--
作者：
Meng J;Lv Q;Yao J;Wang S;Yang K
目的探讨右美托咪定对胸腔镜术后肺损伤的影响。方法2019年3月至2019年10月，将40例患者随机分为右美托咪定组（D组）和对照组（C组）。除术前、术中记录两组患者一般情况外，分别于入院时（T0）、单肺通气后立即（T1）、单肺通气后0.5 h （T2）、吸进空气后15分钟（T3）监测氧合指数（OI）、肺泡-动脉氧分压差（A-aDO2）。采用酶联免疫吸附法（ELISA）测定大鼠T0和T2时动脉血中IL-8的含量，采用免疫组化和Western blot法测定离体肺组织中AQP1蛋白的表达。术后肺部并发症（肺不张、肺炎、急性呼吸窘迫综合征）的发生率作为肺损伤的指标。结果两组患者术前、术中一般情况差异无统计学意义。没有显著差异在两组之间的动脉血液引发内容在T0的时间点,但动脉血液引发内容在T2时间点明显高于在T0的时间点,特别是在C组的免疫组织化学和免疫印迹结果表明AQP1蛋白的表达水平隔离肺组织的D组明显高于C组(P < 0 05)。T3时，D组OI明显高于C组，A-aDO2明显低于C组（P < 0.05）。两组术后PPCs发生率无显著差异。结论右美托咪定可降低单肺通气胸腔镜手术患者血浆IL-8水平，上调肺组织AQP1表达，但对术后PPCs发生率无显著影响。右美托咪定可安全用于胸腔镜手术，对肺损伤有一定的保护作用。
Objective To investigate the effect of dexmedetomidine on postoperative lung injury in patients undergoing thoracoscopic surgery. Methods From March 2019 to October 2019, 40 patients were randomly divided into two groups: dexmedetomidine group (group D) and control group (group C). Except recording the general condition of the patients in both groups preoperatively and intraoperatively, the oxygenation index (OI) and alveolar-arterial oxygen partial pressure difference (A-aDO2) were monitored at admission (T0), immediately after one-lung ventilation (T1), 0.5 h after one-lung ventilation (T2), and 15 minutes after inhaling air before leaving the room (T3). The content of IL-8 in arterial blood was measured by enzyme-linked immunosorbent assay (ELISA) at T0 and T2, and the expression of AQP1 protein in isolated lung tissue was measured by immunohistochemistry and Western blot. The incidence of postoperative pulmonary complications (atelectasis, pneumonia, and acute respiratory distress syndrome) was used as the index of lung injury. Results There was no significant difference in the general condition before and during operation between the two groups. There was no significant difference in arterial blood IL-8 content between the two groups at the T0 time point, but the arterial blood IL-8 content at the T2 time point was significantly higher than that at the T0 time point, especially in group C. The results of immunohistochemistry and Western blot showed that the expression level of AQP1 protein in the isolated lung tissue of group D was significantly higher than that of group C (P < 0 05). At T3, the OI of group D was significantly higher than that of group C, and the A-aDO2 of group D was significantly lower than that of group C (P < 0.05). There was no significant difference in the incidence of postoperative PPCs between the two groups. Conclusion Dexmedetomidine can reduce the level of plasma IL-8 and upregulate the expression of AQP1 in the lung tissue of patients undergoing thoracoscopic surgery under one-lung ventilation, but it has no significant effect on the incidence of postoperative PPCs. Dexmedetomidine can be safely used in thoracoscopic surgery and has a certain protective effect on lung injury.
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影响因子：
4.6
作者：
Wu CY;Lu YF;Wang ML;Chen JS;Hsu YC;Yang FS;Cheng YJ
通讯作者：
Cheng YJ
影响因子：
0.8
作者：
Kernan S;Rehman S;Meyer T;Bourbeau J;Caron N;Tobias JD
通讯作者：
Tobias JD
DOI：
10.12659/msm.896458
发表时间：
2016-08-09
期刊：
Medical science monitor : international medical journal of experimental and clinical research
影响因子：
--
作者：
Huang AX;Lu LW;Liu WJ;Huang M
通讯作者：
Huang M
影响因子：
4.8
作者：
Echevarria, Miriam;Munoz-Cabello, Ana M.;Lopez-Barneo, Jose
通讯作者：
Lopez-Barneo, Jose
影响因子：
5
作者：
An, Li;Liu, Chang-Ting;Yu, Sen-Yang
通讯作者：
Yu, Sen-Yang