Effect Of Dexamethasone On Extravascular Lung Water And Oxygenation Index In Patients With Lobectomy

Objective:To observer the effect of dexamethasone on the perioperative extravascular lung water and oxygenation index(Pa O₂/Fi O₂)of patients with lobectomy,and to provide reference and theoretical basis for the management of perioperative patients.Methods:A total of 80 patients（20-70 years old,ASAⅠ-Ⅱ）who underwent elective thor-acoscopic unilateral lobectomy from August 2020 to December 2020 were randomly divided into a control group（group C,n=20,normal saline 2ml intravenously before induction）,experimental group 1（R1,n=20,dexamethasone 0.2mg/kg intravenously before induction）,experimental group 2（R2,n=20,dexamethasone 0.2mg/kg 24hours before surgery Intravenous injection）,experimental group 3（R3,n=20,dexamethasone 0.2mg/kg intravenous injection 48 hours before surgery）.The B-line score of the patient’s lungs and oxygenation index were recorded at T1 before induction,T2 at the end of surgery,and T3 at 24 hours after surgery.At the same time,record the amount of urine,blood loss,fluid infusion,the amount and type of vasoactive drugs used during the operation,and the amount of fluid infusion 24 hours after the operation.Patients were followed up at 24 hours,48 hours,and 7 days after surgery,and the length of hospital stay and pulmonary complications were recorded.Results:1.There was no statistical difference in the general condition of the patients in each group,the operation time,the amount of in and out of the operation,the amount of infusion 24h after the operation,and the use of intraoperative vasoactive drugs;2.B-line scores at T2 and T3 in each group were higher than those at T1,Pa O2/Fi O2 at T2 and T3 were lower than at T1,the difference was statistically significant（P<0.01）,among which R3 at T2 and T3 The B-line scores of the patients in the group were lower than those in the C group,and there was a statistical difference（P<0.05）,and the Pa O2/Fi O2 was higher than that in the C group,and the difference was statistically significant（P<0.05）;3.Postoperative complications were mainly postoperative nausea and vomiting（PONV）and pneumonia.Compared with group C,the incidence of complications in group R3 was lower,and the difference was statistically significant（P<0.05）;4.The postoperative extubation time of the R3group was shorter than that of the C group,but the difference was not statistically significant（P=0.052）;5.The postoperative hospital stay of the R3 group was shorter than that of the C group,but the difference was not statistically significant（P=0.22）.Conclusion:The use of dexamethasone 48 hours before lobectomy can reduce extravascular pulmonary water production and improve oxygenation.It can shorten the patient’s extubation time,hospital stay,reduce postoperative complications,and help patients recover.