Abstract:
Objective To explore the effect of spontaneous breathing and anesthesia on pulmonary airway inflammation in patients with emphysema.
Methods All of 54 emphysema patients with lung volume reduction surgery from February 2013 to February 2016 were analyzed, it was randomly divided into control group and observation group with 27 cases in each group, the control group using conventional ventilation anesthesia, observation group with spontaneous breathing anesthesia for anesthesia. It was observed that extubation time and recovery time, and the arterial blood gas, inflammation index level and pulmonary function of two groups before and after treatment, and the adverse reactions of the two groups were detected.
Results The extubation time and recovery time of the observation group were shorter than those of the control group. There were significant differences between the two groups (P <0.05). Before treatment, the PaO2 and PaCO2 levels of the two groups had no significant difference (P>0.05). After treatment, the PaO2 and PaCO2 levels of the two groups were compared. The PaO2 of the control group was significantly lower than that of the observation group. The PaCO2 value was significantly lower than that of the observation group (P<0.05). Before treatment, there was no significant difference in the level of inflammatory markers between the two groups (P>0.05). After treatment, the levels of inflammatory markers in the two groups were significantly lower than those before treatment (P<0.05), and IL-6, IL-8 in the control group were significantly higher than those in the observation group (P<0.05). but there was no significant different of TNF-α in two groups(P>0.05). There was no significant difference in FEV1, FVC, FEV1/FVC levels between the two groups before treatment (P>0.05). After treatment, the FEV1, FVC, FEV1/FVC levels of the two groups were significantly higher than those of the control group (P<0.05), and FEV1, FVC, FEV1/FVC of the observation group were significantly higher than those of the control group). There was no significant difference between the two groups in the incidence of adverse reactions (P>0.05).
Conclusions Anesthesia is performed in patients with pulmonary emphysema who underwent lung volume reduction with spontaneous breathing anesthesia, The patients with short extubation time can be easily awake and can improve the blood gas condition, inflammatory reaction and pulmonary function of patients, and reduce the occurrence of adverse reactions. It is more suitable for lung volume reduction emphysema patients compared with conventional mechanical ventilation anesthesia.
Key words:
Emphysema,
Spontaneous breathing anesthesia,
Lung volume reduction,
Inflammation,
Pulmonary function
Lei Wang, Zhiqiang Niu, Mengliang Zheng, Yu Nie, Shuishui Wu. Effect of spontaneous breathing and anesthesia on pulmonary airway inflammation in patients with emphysema[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(06): 690-694.