中国实用口腔科杂志

中国实用口腔科杂志

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不同吸入氧浓度对颌面外科手术麻醉新生儿肺功能及炎症因子影响研究

崔海彬，张倩   

  1. 中国医科大学附属口腔医院麻醉科，辽宁  沈阳  110002
  • 出版日期:2017-08-15 发布日期:2017-09-15
  • 基金资助:

    辽宁省科技攻关项目（2013225220）

  • Online:2017-08-15 Published:2017-09-15

摘要：

目的    探讨麻醉中不同吸入氧浓度（FiO2）对颌面外科手术新生儿肺功能及炎症因子的影响。方法    2015年5月至2016年10月在中国医科大学附属口腔医院接受颌面外科手术新生儿90例，随机分为3组，每组30例，分别吸入35%（A组）、50%（B组）、75%（C组）的氧。分别于术前、术中和术后监测患儿血气、肺功能等指标；ELISA法检测患者外周血炎症因子的变化。结果    3组患儿体重、手术时间、输液量、失血量、尿量等比较差异均无统计学意义（P＞0.05）。麻醉手术机械通气过程中，3组动脉血乳酸、pH、HCO3-值组内不同时间点及组间比较差异均无统计学意义（P＞0.05）。3组患儿术前动脉氧分压（PaO2）正常，A组术中PaO2增高，与术前比较差异有统计学意义（P＜0.05）；术后PaO2有所下降，与术前比较差异有统计学意义（P＜0.05）。B组给氧后PaO2持续升高，差异有统计学意义（P＜0.05）；C组术中PaO2升高，差异有统计学意义（P＜0.05）。A组术后白细胞介素（IL）-1β显著下降，IL-10升高，与术前比较差异有统计学意义（P＜0.05）。结论    麻醉中吸入35%浓度氧对颌面外科手术新生儿肺功能及炎症因子影响最小。

关键词: 机械通气, 氧浓度, 肺损伤, 炎症反应

Abstract:

Objective    To investigate the effects of different concentrations of oxygen inhalation on pulmonary function and inflammatory factors in patients with maxillofacial surgery. Methods    The 90 pediatric patients undergoing maxillofacial surgery in the Affiliated Stomatological Hospital of China Medical University from May 2015 to October 2016 were randomly divided into three groups，35%，50%，75% FiO2 were inhaled. Preoperative，intraoperative and postoperative monitoring was performed on blood gas and lung function index；peripheral inflammatory factor changes were detected by ELISA. Results    There was no significant difference in body weight，operation time，transfusion volume，blood loss or urine volume between the three groups（P＞0.05）. During mechanical ventilation，LA，pH and HCO3- levels were no significant difference among the three groups（P＞0.05）. Preoperative oxygen pressure is normal in the three groups，and oxygen partial pressure was statistically increased compared with preoperative group（P＜0.05）；postoperative oxygen partial pressure decreased，and compared with preoperative，the difference was statistically significant（P＜0.05）. The oxygen partial pressure of B group continued to rise，and the difference was statistically significant（P＜0.05）；the oxygen partial pressure of C group was increased in the operation，and the difference was statistically significant（P＜0.05）. In group A，the IL-1 beta was significantly decreased，and the IL-10 was increased，and compared with the preoperative phase there was significant difference（P＜0.05）. Conclusion    Effects of inhalation of 35% oxygen on pulmonary function and inflammatory factors are least significant in patients undergoing maxillofacial surgery.

Key words: mechanical ventilation, oxygen concentration, lung injury, inflammatory reaction