前列地尔在外科手术中的应用
Masui. 1996 Mar;45(3):304-8.
Effects of prostaglandin E1 on plasma cytokine levels during pneumonectomy
前列腺素E1对肺切除术后血浆细胞因子水平的影响。 [Article in Japanese]
Matsumoto Y, Taniguchi T, Yoneda T, Mori I, Kobayashi H, Yamamoto K, Kobayashi T.
Department of Anesthesiology & Intensive Care Medicine, Kanazawa University, Ishikawa, Japan. Abstract
We investigated the effect of prostaglandin E1 (PGE1) on intraoperative cytokine responses and the incidence of postoperative
complications. Twenty-six patients undergoing elective pneumonectomy were randomly allocated into PGE1 group (n = 12) and control group (n = 14). The PGE1 group received continuous infusion of PGE1 during surgery at a dose of 0.02-0.03 microgram.kg-1.min-1. Blood samples were obtained after induction of general anesthesia, one and two hours after incision, and immediately after the end of surgery to measure the plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and interleukin-8 (IL-8). Levels of CRP for two days after the surgery were measured and postoperative complications were recorded. Levels of
TNF-alpha rose from 1.6 pg.ml-1 (mean) to 4.8 pg.ml-1 two hr after incision in the control group, while the level was suppressed in the PGE1 group (P < 0.05). No significant difference was found in IL-6 levels between the two groups. The IL-8 increased during surgery in both groups but the increase was significantly less in the PGE1 group (P < 0.05). There was no difference in CRP, and no severe postoperative complication was observed. We conclude
that PGE1 administration suppresses TNF-alpha and IL-8 responses during pneumonectomy, but its effects on IL-6 and the postoperative status were not significant.
PMID: 8721128 [PubMed - indexed for MEDLINE]
研究前列腺素E1对手术中细胞因子的影响以及对手术后并发症的作用。将26位肺切除病人分为两组：PGE1组和对照组。PGE1 组在手术中持续灌注PGE1 20-30ug/kg.min，之后取血样，测TNF肿瘤坏死因子的水平， 白介素-6(IL-6)，白介素-8(IL-8)，手术后两天测CRP的水平。对照组，手术后两小时TNF水平由 1.6 pg.ml-1 (mean) to 4.8 pg.ml-1，但是在PGE1组，升高的TNF被抑制。但两组的白介素-6水平变化没有显著差异。白介素-8(IL-8)在两组均有升高，但是PGE1组升高的幅度小于对照组。结论：前列腺素E1减少TNF和白介素-8在肺切除术中的生成。
J Am Coll Surg. 1996 Oct;183(4):371-6. http://www.ncbi.nlm.nih.gov/pubmed/8843266
Prostaglandin E1 ameliorates decreased tracheal blood flow after esophagectomy and aggressive upper mediastinal lymphadenectomy for esophageal carcinoma.
前列腺素E1可以改善食管癌食管切除术后和纵膈淋巴切除术后的食管血流。 Hasegawa S, Imamura M, Shimada Y, Kanda Y, Wada H, Hitomi S, Mori K. Department of Critical Care Medicine, Kyoto University Hospital, Japan. Abstract
BACKGROUND: Aggressive upper mediastinal lymphadenectomy contributes to a better survival rate after esophageal resection to treat esophageal carcinoma, but it also increases postoperative respiratory complications. Devascularization of the airways because of mediastinal dissection is considered to be a cause of respiratory dysfunction. The present study attempts to clarify whether or not tracheal blood flow (TBF) deteriorates after esophagectomy and, if so, whether or not intravenous prostaglandin E1 (PGE1) attenuates the deterioration. STUDY DESIGN: Patients undergoing
esophagectomy and aggressive upper mediastinal lymphadenectomy for the treatment of esophageal carcinoma (EC group, n = 12) or abdominal surgery (control group, n = 6) were enrolled in this study. Measurement of TBF was performed using a laser Doppler flowmeter. Changes in TBF induced by surgery and postoperative intravenous PGE1 were studied in both groups. RESULTS: The TBF deteriorated significantly in the EC group (21.78 +/- 9.60 to 11.24 +/- 4.45 mL/minute/10(-1) kg, p = 0.002) but did not change in the control group (26.13 +/- 6.84 to 26.61 +/- 4.69 mL/minute/10(-1) kg, p = 0.7371). Postoperative intravenous PGE1 partially, but significantly, reversed the deterioration in TBF in the EC group (11.53 +/- 4.58 to 14.87 +/- 6.30 mL/minute/10(-1) kg, p = 0.0207) but did not effect the control group (29.41 +/- 7.89 to 29.41 +/- 8.79 mL/minute/10(-1) kg, p = 0.9989). CONCLUSIONS: Esophagectomy and aggressive upper mediastinal lymphadenectomy cause a deterioration in TBF that is partially attenuated by PGE1. PMID: 8843266 [PubMed - indexed for MEDLINE]
Masui. 2002 Apr;51(4):377-81. http://www.ncbi.nlm.nih.gov/pubmed
Effect of prostaglandin E1 infusion during and after total hip arthroplasty under hypotensive anesthesia on postoperative liver function and hemorrhage
前列地尔在外科手术中的应用教学提纲
