CAJ | 학술논문

目的：探讨氨溴索联合乌司他丁对食管癌手术患者肺损伤的保护作用。方法选择拟行食管癌根治术患者85例，分为氨溴索组（ n＝27）、乌司他丁组（ n＝28）和联合组（ n＝30）。在食管癌手术过程中，氨溴索组采用盐酸氨溴索治疗，乌司他丁组采用乌司他丁治疗，联合组联合使用盐酸氨溴索和乌司他丁。比较3组患者围手术期间不同时间点的桡动脉血p（O2）、PA-aDO2、RI及TNF-α、IL-6、SP-D的浓度。结果3组t1、t2、t3时p（O2）、PA-aDO2、RI及TNF-α、IL-6、SP-D明显高于t0时（P均＜0．05）；联合组t1、t2、t3时p （O2）明显高于氨溴索组和乌司他丁组（P均＜0．05），PA-aDO2、RI则明显低于氨溴索组和乌司他丁组（ P均＜0．05）。联合组t1、t2、t3时TNF-α、IL-6、SP-D明显低于氨溴索组和乌司他丁组（ P均＜0．05）。结论与单一应用氨溴索或乌司他丁相比，两药联合应用能更明显地抑制食管癌根治术患者围术期的炎性反应，提高肺顺应性，促进肺部气体交换，减轻肺损伤。
목적：탐토안추색연합오사타정대식관암수술환자폐손상적보호작용。방법선택의행식관암근치술환자85례，분위안추색조（ n＝27）、오사타정조（ n＝28）화연합조（ n＝30）。재식관암수술과정중，안추색조채용염산안추색치료，오사타정조채용오사타정치료，연합조연합사용염산안추색화오사타정。비교3조환자위수술기간불동시간점적뇨동맥혈p（O2）、PA-aDO2、RI급TNF-α、IL-6、SP-D적농도。결과3조t1、t2、t3시p（O2）、PA-aDO2、RI급TNF-α、IL-6、SP-D명현고우t0시（P균＜0．05）；연합조t1、t2、t3시p （O2）명현고우안추색조화오사타정조（P균＜0．05），PA-aDO2、RI칙명현저우안추색조화오사타정조（ P균＜0．05）。연합조t1、t2、t3시TNF-α、IL-6、SP-D명현저우안추색조화오사타정조（ P균＜0．05）。결론여단일응용안추색혹오사타정상비，량약연합응용능경명현지억제식관암근치술환자위술기적염성반응，제고폐순응성，촉진폐부기체교환，감경폐손상。
Objective It is to investigate the protective effect of ambroxol combined with ulinastatin on lung injury in pa -tients after esophageal carcinoma operation .Methods 85 patients designed for radical resection of esophageal carcinoma were divided into ambroxol group (n=27), ulinastatin group(n=28) and combination group(n=30).During esophageal cancer operation process , the patients were treated with hydrochloride ambroxol in ambroxol group , with ulinastatin in ulinastatin group, and with hydrochloride ambroxol combined with ulinastatin in combination group .The value of p(O2), PA-aDO2, RI and the concentrations of TNF -α, IL-6, SP-D of radial artery blood at different time points of perioperative period were compared among three groups.Results The value of p(O2),PA-aDO2, RI and the concentrations of TNF -α, IL-6 and SP-D at t1, t2, t3 in each groups were higher than those at t0(all P<0.05);the p(O2) at t1,t2,t3 in combination group was significantly higher than those in ambroxol group and ulinastatin group (all P<0.05), the PA-aDO2 and RI was significant-ly lower than those in ambroxol group and ulinastatin group (P<0.05).The TNF-α, IL-6, SP-D at t1, t2, t3 in combi-nation group was significantly lower than those in ambroxol group and ulinastatin group (P<0.05).Conclusion compared with single application? of ambroxol or Ulinastatin , two drug’ s combination can more markedly inhibit the cure inflammatory reaction of patietns after esophageal carcinoma operation , and increase lung compliance , promote pulmonary gas exchange , al-leviate lung injury .