Effect Of Sevoflurance Or Propofol On Inflammatory Factors And Pulmonary Function In Lung Cancer Patients During Preioperative

Objective:y observing the changes of serum matrix metalloproteinase-9(MMP-9),malondialdehyde(MDA) concentration and alveolar arterial oxy-gen difference (A-aD02), respiratory index (RI), intrapulmonary shunt ratio (Qs/Qt) and pulmonary dynamic compliance (Cdyn) in patients with lung can-cer. To compare the effect of Sevoflurane inhalation anesthesia only and propofol total intravenous anesthesia on inflammatory factors and pulmon-ary function in lung cancer patients during preioperative.Methods:30 patients with lung cancer scheduled for simple lobectomy of the left lung lower lobe, ASAⅠ～Ⅱgrade,23 cases were male and fe-male, aged 41 to 65 years old, body mass index was 22-30kg/m2, preoperative echocardiography and pulmonary function tests show heart and lung func-tion were normal, excluding rheumatic, chronic inflammatory and autoimmune diseases, liver and kidney function no obvious abnormalities, no hyperten-sion, diabetes, none of these patients received preoperative treatment, no smoking or had quitted smoking for more than 8 weeks, three weeks without taking hormones or nonsteroidal antiinflammatory drug.no intraoperative bleeding no transfusion blood products, postoperative pathology confirmed no local and distant metastasis,were randomly divided into two groups (n:15):sevoflurane group (S group) and propofol group (P group). The moment before induction of anesthesia(To), before the start of one-lung ventila-tion (T1), before the end of one-lung ventilation(T2), after closed chest su-rgery (T3), after 24h(T4), take radial artery and mixed Venous blood, do gas analysis, calculate alveolar-arterial oxygen difference(A-aD02),respir-etory index(RI), and intrapulmonary shunt ratio(Qs/Qt);At To, T3, T4, radial arterial blood samples were taken to measure serum matrix metalloprotei-nase-9 (MMP-9) and malondialdehyde (MDA) concentration;at T1, T2, T3, record the tidal volume(VT),airway plateau pressure(Pplat) and endex-piratory positive airway pressure(PEEP), calculate pulmonary dynamic compliance (Cdyn); record heart rate (HR), mean arterial pressure (MAP), central venous pressure(CVP), cardiac output(CO) and single-lung ventilation(OLV-T).Result:Compared with To, both groups'A-aD02, RI, and Qs/Qt increased significantly (P<0.05 or 0.01) at T1-3;at T3, the concentration of MMP-9 and MDA increased significantly (P<0.01). Compared with T1, the Cdyn of S group reduced at T3 (P<0.05). Compared with P group, S group's A-aD02, the concen-tration of MMP-9 and MDA increased at T3(P<0.05);RI increased at T2,3 (P<0.05); Qs/Qt increased at T1-3(P<0.05 or 0.01).Conclusion:Propofol is a better anesthetic for lung resection than sevoflurane in terms of oxygenation. It causes less inflammatory mediator release and intrapulmonary shunt induced by one-lung ventilation and surgical trauma than sevoflurane.