【摘要】 目的探讨胸部CT指导双腔支气管导管插管对患者应激反应蛋白水平的影响。方法选取河北省承德市中心医院2016年1月～2018年1月诊治的拟行全身麻醉单肺通气下行胸科手术患者90例为研究对象,采用随机数字表法分为对照组(n=50)和观察组(n=40)。对照组患者采用传统插管法,观察组患者采用胸部CT指导双腔支气管导管插管,比较两组的临床效果及插管前后应激反应蛋白水平。结果两组的单肺通气时间和麻醉时间比较,差异无统计学意义(P> 0.05);观察组的插管时间短于对照组,插管尝试次数少于对照组(P <0.05)。两组插管后丙二醛(MDA)水平均较插管前明显升高(P <0.05),超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)水平均较插管前明显降低(P <0.05),且观察组的变化幅度较小(P <0.05)。两组插管后C反应蛋白(CRP)、白细胞介素-1β及白细胞介素-6水平均较插管前明显升高(P <0.05),且观察组的变化幅度较小(P <0.05)。观察组术后24 h声嘶及术后24 h咽喉痛的发生率明显低于对照组,差异有统计学意义(P <0.05)。结论胸部CT指导双腔支气管导管插管的临床效果好,且对应激反应的刺激较弱。更多还原

【Abstract】 Objective To investigate the effect of CT-guided double-lumen bronchial catheterization on stress response protein level in patients. Methods 90 patients undergoing thoracic surgery under general anesthesia and one-lung ventilation from January 2016 to January 2018 in Chengde Central Hospital of Hebei Province were selected as the study subjects. They were divided into control group(n=50) and observation group(n=40) by random number table method. Patients in control group were treated with traditional intubation method, while patients in observation group were treated with double-lumen bronchial tube intubation guided by chest CT. The clinical effects and stress response protein levels before and after intubation were compared between two groups. Results There was no significant difference in one lung ventilation time and anesthesia time between two groups(P > 0.05); the intubation time of observation group was shorter than that of control group, and the number of intubation attempts of observation group was less than that of control group(P < 0.05). After intubation, MDA levels in both groups were significantly higher than those before intubation(P < 0.05), SOD and GSH-px levels were significantly lower than those before intubation(P < 0.05), and the changes in observation group were smaller(P < 0.05). After intubation, the levels of CRP, IL-1β and IL-6 in two groups were significantly higher than those before intubation(P < 0.05), and the changes in observation group were smaller(P < 0.05). The incidence of hoarseness and sore throat at 24 hours after operation in observation group was significantly lower than that in control group(P < 0.05). Conclusion Chest CT guided double-lumen bronchial catheter intubation has good clinical effect and less stimulation to stress response.更多还原