前列地尔在外科手术中的应用.doc

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 JapaneseMatsumoto Y, Taniguchi T, Yoneda T, Mori I, Kobayashi H, Yamamoto K, Kobayashi T.Department of Anesthesiology & Intensive Care Medicine, Kanazawa University, Ishikawa, Japan.AbstractWe 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. /pubmed/8843266Prostaglandin 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.AbstractBACKGROUND: 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 MEDLINEMasui. 2002 Apr;51(4):377-81. /pubmedEffect of prostaglandin E1 infusion during and after total hip arthroplasty under hypotensive anesthesia on postoperative liver function and hemorrhage髋关节置换术麻醉容易引发肝损伤和肝出血，前列地尔在手术中持续灌注可以预防这一并发症的发生Article in JapaneseIkeya K, Kume M, Sato H, Kashimoto S, Kumazawa T.Department of Anesthesia, Kofu Municipal Hospital, Kofu 400-0832.AbstractWe evaluated the effects of prostaglandin E1 (PGE1) on the liver function and hemorrhage after total hip arthroplasty (THA). Twenty patients with normal liver function were randomly divided into two groups. The patients were anesthetized with spinal anesthesia using 0.5% bupivacaine 4 ml and epidural anesthesia. The laryngeal mask was inserted after administrations of 1.5-2 mg.kg-1 of propofol and 0.8 mg.kg-1 of succinylcholine. PGE1 was infused in the PGE1 group at a rate of 0.01 microgram.kg-1.min-1 (PGE1 group) during and after the operation (30-40 hrs). GOT and GPT values were evaluated before, and at the end of operation, and on 1, 4 and 7 postoperative days in each group. The amount of hemorrhage was measured at the end of operation and on 1, 2, 3 and 4 postoperative days in each group. GOT values on 1 and 4 postoperative days in PGE1 group were significantly lower than those in the control group. GPT values on 1, 4 and 7 postoperative days in PGE1 group were also significantly lower than those in the control group. The amount of bleeding during the operation and postoperative hemorrhage did not differ significantly between the two groups. These results suggest that PGE1 may prevent postoperative liver damage, but it may not affect the amount of postoperative bleeding.PMID: 11995344 PubMed - indexed for MEDLINEAnesth Analg. 1999 Feb;88(2):446-51./pubmedThe effects of prostaglandin E1 on intraoperative temperature changes and the incidence of postoperative shivering during deliberate mild hypothermia for neurosurgical procedures.前列腺素E1对脑神经外科术后病人寒战和体温改变的作用。Kawaguchi M, Inoue S, Sakamoto T, Kawaraguchi Y, Furuya H, Sakaki T.Department of Anesthesiology, Nara Medical University, Japan.AbstractWe investigated the effects of i.v. prostaglandin E1 (PGE1) on intraoperative changes of core temperature and the incidence of postoperative shivering in neurosurgical patients undergoing deliberate mild hypothermia. Eighty-three patients were randomly assigned to one of three groups: patients in the control group did not receive PGE1, whereas patients in the PG20 group and PG50 group received PGE1 at a dose of 0.02 and 0.05 microg x kg(-1) x min(-1), respectively. The administration of PGE1 was started just after the induction of anesthesia and continued until the end of anesthesia. Anesthesia was maintained with nitrous oxide in oxygen, sevoflurane, and fentanyl. After the induction of anesthesia, patients were cooled using a water blanket and a convective device blanket. Tympanic membrane temperature was maintained at 34.5 degrees C. During surgical wound closure, patients were rewarmed. Intraoperative changes in tympanic membrane and skin temperatures and the incidence of postoperative shivering were compared among groups. Demographic and intraoperative variables were similar among groups. There were no significant differences in tympanic temperatures among groups at each point during the operation. Skin temperature 30 min after rewarming and just after tracheal extubation was significantly lower in the PG20 group than in the PG50 group. Postoperative shiveri