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目的探讨帕瑞昔布钠和氟比洛芬酯对食管癌根治术患者单肺通气时肺内分流的影响。方法择期行食管癌根治术患者30例随机均分为帕瑞昔布钠组(P组)、氟比洛芬酯组(F组)和对照组(C组)。P组和F组分别于麻醉诱导时静脉注射帕瑞昔布钠40mg和氟比洛芬酯50mg,C组给予等容量生理盐水。于气管插管后双肺通气5min(T0)、侧卧位后10min(T1)、单肺通气30min(T2)、恢复双肺通气15min(T3)时测定HR、MAP、平均气道压(Pmean),并行血气分析,计算肺内分流率(Qs/Qt)。结果三组各时点的HR、MAP、SpO2差异均无统计学意义(P>0.05)。与T0、T1时比较,三组T2时PaO2均降低,Pmean和Qs/Qt均升高(P<0.05);与T2时比较,三组T3时PaO2均升高,Pmean和Qs/Qt均降低(P<0.05)。与C组比较,T2时P组、F组PaO2升高,Qs/Qt降低(P<0.05);各时点P组、F组之间PaO2、Qs/Qt差异均无统计学意义(P>0.05),三组之间同时点Pmean差异均无统计学意义(P>0.05)。结论帕瑞昔布钠或氟比洛芬酯可降低食管癌根治术患者单肺通气时的肺内分流。
Objective To investigate the effects of parecoxib sodium and flurbiprofen axetil on pulmonary shunt during single lung ventilation in patients undergoing radical resection of esophageal cancer. Methods Thirty patients undergoing esophageal cancer radical resection were randomly divided into Parecoxib group (P group), Flurbiprofen axetil group (F group) and control group (C group). P group and F group were injected intravenously with parecoxib sodium 40mg and flurbiprofen axetil 50mg respectively during the induction of anesthesia. Group C was given the same volume of normal saline. HR, MAP and mean airway pressure (Pmean) were measured at 5 min (T0), 10 min (T1), one lung ventilation 30 min (T2) ), Parallel blood gas analysis, calculate the rate of pulmonary shunt (Qs / Qt). Results There were no significant differences in HR, MAP and SpO2 between the three groups at each time point (P> 0.05). Compared with T0 and T1, the PaO2 of both groups decreased and Pmean and Qs / Qt increased at T2 (P <0.05). Compared with T2, the PaO2 at T3 and the Pmean and Qs / Qt decreased (P <0.05). Compared with group C, PaO2 and Qs / Qt of group P and group F were decreased (P <0.05) at T2, and there was no significant difference of PaO2 and Qs / Qt between group P and group F at each time point (P> 0.05). There was no significant difference in Pmean between the three groups at the same time (P> 0.05). Conclusions Parecoxib sodium or flurbiprofen axetil decreases pulmonary shunt during single lung ventilation in patients undergoing radical surgery for esophageal cancer.