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参附注射液对止血带引起的下肢缺血-再灌注肺损伤的影响 被引量:4

Lung protective effect of Shenfu injection on the legs' ischemia-reperfusion injury
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摘要 目的探讨参附注射液对止血带引起的下肢缺血-再灌注肺损伤的影响。方法选择行单侧下肢手术患者60例,男36例,女24例,ASAⅠ或Ⅱ级。将患者随机分为参附注射液组(SF组,n=32)和对照组(C组,n=28)。两组患者均采用腰-硬联合麻醉,给予0.75%布比卡因1.5ml,上电脑气压止血带(压力为300mm Hg)止血。SF组于上止血带致缺血前30min静脉泵入参附注射液1ml/kg(加入100ml生理盐水中),松止血带前5min再次泵入1ml/kg(加入50ml生理盐水中);C组在相同时点分别静脉注射等量复方乳酸钠。记录上止血带前(T0)、松止血带后5min(T1)、15min(T2)、30min(T3)的MAP和HR;采集静脉血测定血浆血栓素B2(TXB2)和丙二醛(MDA)浓度。结果与T0时比较,T1~T3时两组MAP明显降低(P〈0.05);T2、T3时SF组MAP明显高于C组(P〈0.05)。两组患者HR组间组内差异均无统计学意义。T2、T3时SF组TXB2和MDA浓度明显低于C组(P〈0.05或P〈0.01)。结论参附注射液具有抗氧化作用,可减轻止血带所致的下肢缺血-再灌注肺损伤。 Objective To discuss the lung protective effect of Shenfu injection on the legs' ischemia-reperfusion injury.Methods Sixty patients (6 males, 24 females, ASA grade Ⅰ or Ⅱ)with unilateral lower limb surgery, were randomly divided into Shenfu injection group (group SF, n=32) and control group (group C, n=28).All patients were treated by combined spinal epidural anesthesia, with the same dose of local anesthetic (0.75% bupivacaine 1.5 ml and the same pressure (300mm Hg) of tourniquet.Patients in group SF were given intravenous infusion of Shenfu injection with the dose of 1 ml/kg (added in normal saline 100 ml) 30 min before apply tourniquet and 1 ml/kg (added in nomal saline 50 ml) 5 min before tourniquet deflation.Patients in group C were injected with equal dose of compound sodium lactate at the same time.Recorded the hemodynamic changes before apply tourniquet (T0) and 5 min (T1), 15 min (T2) and 30 min (T3) after tourniquet deflation.Took venous blood to determine concentrations of plasma thromboxane B2 (TXB2) and malondialdehyde (MDA).Results Compared with T0, MAP in the two groups were significcantly lower at T1-T3 (P〈0.05).MAP in group SF at T2 and T3 were higher than those in group C (P〈0.05).There was no significant difference in HR between the two groups.TXB2 and MDA in group SF at T2 and T3 were significantly lower than those in group C (P〈0.05 or P〈0.01).Conclusion Shenfu injection with antioxidation has a protective effect on lower limb ischemia-reperfusion lung injury induced by tourniquet.
作者 朱美华 张家敏 牛聪 陈志勇 ZHU Meihua , ZHANG Jiamin , NIU Cong , CHEN Zhiyong. (Department of Anesthesiology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210017, China)
出处 《临床麻醉学杂志》 CSCD 北大核心 2017年第7期680-682,共3页 The Journal of Clinical Anesthesiology
基金 南京市科技计划项目(201611004)
关键词 参附注射液 缺血-再灌注损伤 肺保护作用 Shenfu injection Ischemia-reperfusion injury Lung protective effect
作者简介 通信作者:朱美华,Email:zhu_zmh@163.com
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