塞沃弗卢兰对老年慢性阻塞性肺病患者的肺功能具有保护作用,这些患者接受了全关节整形术
Yuan Yao1, Man-Si Zhang2, Yue-Bing Li3
1Department of Anesthesiology, The Second Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China.
World journal of clinical cases
|December 11, 2023
概括
在接受部手术的慢性阻塞性肺病 (COPD) 的老年患者中,sevoflurane麻醉显著减少了术后的肺部并发症. 它还改善了肺功能和疼痛减轻与propofol相比.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 老年医学 老年医学
背景情况:
- 患有慢性阻塞性肺病 (COPD) 的老年患者在进行重大手术后面临术后肺部并发症 (PPC) 的风险增加.
- 作为一种挥发性麻醉剂的sevoflurane具有抗炎和抗氧化特性,在动物模型中显示出减轻肺损伤的潜力.
研究的目的:
- 评估sevoflurane对经过全关节整形手术 (THA) 的老年COPD患者肺功能的保护作用.
主要方法:
- 一项随机对照试验,涉及120名老年COPD患者,计划接受THA.
- 患者被分配给接受sevoflurane或propofol用于维持麻醉.
- 主要结局:七天内发生PPC;次要结局:肺功能,炎症标志物,氧化应激和疼痛.
主要成果:
- 在sevoflurane组 (10%) 与propofol组 (25%) (P = 0.02) 中,PPC的发生率明显较低.
- 在手术后24小时和48小时 (P <0.05) 的肺功能参数 (FEV1,FVC,PEF) 的下降显著较小.
- 在西沃弗卢兰组 (P <0.05) 观察到炎症标志物 (IL-6,TNF-α) 和氧化应激标志物 (MDA,8-OHdG) 的较低水平,以及手术后疼痛的减少.
结论:
- 塞沃弗兰为老年COPD患者提供肺部保护,这些患者在全身麻醉下接受THA治疗.
- 它有效地减少PPC,炎症和氧化应激反应,并缓解术后疼痛.
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