Effect of ulinastatin on postoperative outcomes in elderly patients undergoing thoracoscopic radical operation for lung cancer
10.3760/cma.j.issn.0254-1416.2018.12.010
- VernacularTitle:乌司他丁对胸腔镜肺癌根治术老年患者术后转归的影响
- Author:
Gang XU
1
;
Xihua LU
Author Information
1. 450008,郑州大学附属肿瘤医院麻醉科
- Keywords:
Trypsin inhibitors;
Thoracoscopy;
Aged;
Prognosis
- From:
Chinese Journal of Anesthesiology
2018;38(12):1445-1448
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of ulinastatin on postoperative outcomes in elderly patients undergoing thoracoscopic radical operation for lung cancer.Methods Sixty patients of both sexes,aged 65-80 yr,weighing 40-85 kg,of American Society Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for thoracoscopic radical operation for lung cancer,were divided into 2 groups (n =30 each) using a random number table method:ulinastatin group (group UTI) and normal saline group (group NS).Ulinastatin 0.5× 104 U/kg was intravenously infused within 1 h before skin incision in group UTI,while the equal volume of normal saline was given instead in group NS.Central venous blood samples were collected at 30 min before skin incision (T0),30 min after start of surgery (T1),and 1 h and 1,3 and 5 days after surgery (T2-5) for determination of the expression of CD42a+,HLADR+ and CD14+ in monocytes (using the flow cytometry),plasma concentrations of interleukin-6 (IL-6),IL-8 and tumor necrosis factoralpha (TNF-α) (by enzyme-linked immunosorbent assay),and the plasma C-reactive protein (CRP) concentration (by immunoturbidimetry).The ratios of monocyte-platelet adhesion (CD42a+/CD14+) and monocyte activation function (HLADR+/CD14+) were calculated.Cognitive function was assessed and scored on day 1 before operation and day 7 after operation,and the incidence of postoperative cognitive dysfunction (POCD) was calculated using Z score.Results Compared with group NS,the CD42a+/CD14+ ratio was significantly decreased at T1-3,the HLADR+/CD14+ ratio was increased at T3,4,the concentrations of plasma IL-6,IL-8,TNF-α and CRP were decreased at T1-5,and the incidence of POCD was decreased in group UTI (P＜0.05).Compared with the baseline value at T0,the HLADR+/CD14+ ratio was significantly decreased at T2-4 in group UTI,the HLADR+/CD14+ ratio was decreased at T2-5,and the CD42a+/CD14+ ratio was increased at T1,2 and T4,5 in group NS,and the concentrations of plasma IL-6,IL-8,TNF-α and CRP were increased at T1-5 in the two groups (P＜0.05).Conclusion Ulinastatin can promote postoperative outcomes in the elderly patients undergoing thoracoscopic radical operation for lung cancer.
