The Pulmonary Protective Effect Of Dexmedetomidine-Ketamine Combination In Surgery For Esophageal Cancer

Objective：Observe in esophageal cancer surgery with single-lung ventilation,the changes ofhemodynamic、arterial blood gas and inflammatory cytokine in the blood.To evaluatethe protective effect of dexmedetomidine-ketamine combination to patients withesophageal cancer surgery.provide a theoretical basis for the prevention and treatmentof single-lung mechanical ventilation-induced lung injury.Methods：36cases ASA I～Ⅱ patients;were randomly divided two groups of18each;control group and combination group.After induction,the D+K group slowinfusion dex1ug/kg/h、ket1mg/kg.static pump1h.give saline in C group.beforeinduction（T1）、single-lung ventilation1h（T2）、2h（T3）、and after4h（T4）.measurementof HR、MAP.take the peripheral arterial blood determination of PH、PaO₂、PaCO2、ABG.Used ELISA determination of TNF-a、IL-6、IL-8、IL-10concentration.Results：（1） No significant difference of age、gender、weight、operation time、one-lungventilation time in two groups.（2） Compared with T1,the two groups of HR、MAP,after surgery was increase（P<0.05）. compared with C.D+K group HR、MAP amplitude was small-（P<0.05）.（3） Compared with T1,two groups PH was increased（P<0.05）. compared with C.D+K group PH of the relative increased in small （P<0.05）. compared with T1, PaO₂、PaCO₂of post-operative was lower（P<0.05）, compared with C.D+K group PaO₂、PaCO₂was reduced small（P<0.05）.（4） Compared with T1,the two groups with serum levels of TNF-a、IL-6、IL-8、IL-10significantly increased（P<0.05）. compared with C. D+K group T3、T4phase ofTNF-a、IL-6、IL-8was low, IL-10increased（P<0.05）.Conclusion：1.Esophageal carcinoma perioperative plmomary inflammation was enhan-ced,inflammatory cytokines TNF-a、IL-6、IL-8increased（P<0.05）. 2.Anti-inflammatory cytokines IL-10increased in D+K group3.Dexmedetomidine-ketamine combination have anti-inflammtory and lung pro-tective effect.