不同的吸入氧度与雾化前列腺素E1相结合对接受单肺通风的患者的氧化的影响:随机对照试验
Lingxi Xing1, Halisa Paerhati1, Yuyan Ding1
1Department of Anesthesiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, 210009, China.
BMC anesthesiology
|May 6, 2025
概括
前列腺素E1 (PGE1) 在食管癌手术患者的单肺通风 (OLV) 期间有效改善氧化. 为了获得更好的结果,建议使用0.4 FiO2加0.1μg/kg PGE1的疗法.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 单肺通风 (OLV) 需要高吸入氧度 (FiO2),增加术后肺部并发症的风险.
- 调查前列腺素E1 (PGE1) 作为减少OLV期间FiO2和减轻并发症的战略.
研究的目的:
- 评估PGE1在OLV期间对氧化的影响.
- 评估PGE1对术后肺部并发症和炎症标志物的影响.
主要方法:
- 120名因食道癌而接受选择性左胸切除术的患者被随机分为四组.
- 这些组接受了不同水平的FiO2 (0.4-0.6) 有或没有PGE1 (0.1μg/kg) 或正常盐水.
- 主要结局:OLV期间的氧化;次要结局:肺内突变,肺部并发症和炎症性细胞因子.
主要成果:
- 与对照组相比,PGE1的使用,特别是0.4 FiO2,显著改善了氧化 (PaO2,PaO2/FiO2).
- 雾化PGE1降低了介质素-6和瘤亡因子-α水平,并降低了临床肺部感染评分 (CPIS).
- 在术后并发症,肺胸炎,肺部感染或住院时间的总体发病率方面没有发现显著差异.
结论:
- PGE1显著降低氧气不足,并在OLV期间改善氧化,特别是在较低的FiO2 (0.4) 时.
- 建议将0.4 FiO2和0.1μg/kg PGE1的组合作为适当的临床治疗方案.
- 在接受OLV的患者中,PGE1在控制氧化和炎症方面表现有前途.
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