帕瑞昔布钠对体外循环术后患者肺氧合功能及血清IL-6、IL-10的影响

张岳农

帕瑞昔布钠对体外循环术后患者肺氧合功能及血清IL-6、IL-10的影响

张岳农

Influence of Parecoxib Sodium on Pulmonary Oxygenation Function and Serum IL-6, IL-10 of Patients after Cardiopulmonary Bypass Surgery

摘要

摘要: 目的：观察帕瑞昔布钠对体外循环（CPB）术后患者肺氧合功能及血清白介素-6（IL-6）、白介素-10（IL-10）的影响。方法：选取我院收治的拟行CPB下心脏瓣膜置换术患者135例作为研究对象，按照随机数字表法分为A组、B组和C组各45例。术毕前20 min，A组静脉注射帕瑞昔布钠40 mg，B组静脉注射帕瑞昔布钠20 mg，C组静脉注射等容量生理盐水。观察3组临床指标、动脉血氧含量（CaO2）和肺泡-动脉血氧分压差（PA-aO2）、肺泡氧合指数（OI）以及IL-6和IL-10水平。结果：3组机械通气时间、住ICU时间、住院时间比较差异无统计学意义（P＞0.05）；A组术后12 h、48 hCaO2水平显著高于B组和C组（P＜0.05），PA-aO2水平显著低于B组和C组（P＜0.05），B组和C组术后12 h、48 hCaO2、PA-aO2水平比较差异无统计学意义（P＞0.05）；A组拔管前1 h、3 h OI水平显著低于B组和C组（P＜0.05），B组和C组比较差异无统计学意义（P＞0.05）；A组术后12 h、48 hIL-6显著低于B组和C组（P＜0.05），IL-10水平显著高于B组和C组（P＜0.05），B组和C组IL-6、IL-10水平比较差异无统计学意义（P＞0.05）。结论：术毕前20 min静脉注射40 mg帕瑞昔布钠能够有效调节CPB术后患者血清水平，保护肺损伤，改善肺氧合功能。

Abstract: Objective: To observe the influence of parecoxib sodium on pulmonary oxygenation function and serum IL-6, IL-10 of patients after cardiopulmonary bypass surgery. Methods: 135 cases of patients with cardiac valve replacement treated in our hospital under CPB were selected as the study objects, and were divided into group A, group B and group C, 45 cases in each group. Before 20min at the end of the surgery, group A were given intravenous injection of parecoxib sodium 40 mg, group B were given intravenous injection of parecoxib sodium 20 mg, and group C were given intravenous injection of normal saline in equal capacity. The control group were given routine nursing intervention, and the study group were given full featured rehabilitation nursing of traditional Chinese Medicine intervention on the basis of the control group. Clinical parameters, arterial oxygen content (CaO2) and Alveolar arterial oxygen partial pressure difference (PA-aO2), alveolar oxygenation index (OI) and IL-6 and IL-10 levels were observed in the three groups. Results:There were no significant differences in mechanical ventilation time, ICU time, hospitalization time among the three groups (P > 0.05) , which of group B were significantly lower than those of group C(P < 0.05). At postoperative 12h, 48h, CaO2 level in group A was significantly higher than that of group B and group C (P < 0.05), and PA-aO2 levels were significantly lower than that in group B and group C (P < 0.05), with no statistically significant differences in CaO2 and PA-aO2 levels between group B and group C(P > 0.05). At 1 h, 3 h before getting out of the extubation, OI level in group A were significantly lower than that in grroup B and group C (P < 0.05), with no statistically significant difference between group B and group C(P > 0.05). At postoperative 12h, 48h, HIL-6 in group A were significantly lower than that in group B and group C (P < 0.05). IL-10 level was significantly higher than that of group B and group C(P < 0.05). There were no significant differences in levels of IL-6 and IL-10 in group B and group C (P > 0.05). Conclusion: Before 20min at the end of the surgery, intravenous injection of parecoxib sodium 40 mg can effectively adjust serum levels of patients after CPB, protect lung injury, and improve lung oxygenation function

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