氢气吸入对肺癌根治患者术后谵妄的影响

研究旨在探讨氢气吸入对老年胸腔镜肺癌根治患者术后谵妄（postoperative delirium，POD）的影响。选取2020年6月至2021年5月天津医科大学总医院收治的124例全身麻醉下行胸腔镜肺癌根治患者作为研究对象，按照随机数字表法分为观察组（吸入66.7%的氢气）和对照组（吸入33.3%的氧气），每组62例。比较两组患者单肺通气前5 min（T0）、单肺通气结束时（T1）的氧饱和度、氧合指数、肺动态顺应性、白细胞介素（interleukin，IL-6）、超氧化物歧化酶（superoxide dismutase，SOD）；观察两组患者术后1、3、7 d的谵妄发生率。结果显示，T0时间点，两组患者氧饱和度、氧合指数、肺动态顺应性、IL-6和SOD比较，差异无统计学意义（P<0.05）；T1时间点，观察组氧饱和度、氧合指数、肺动态顺应性、SOD均显著高于对照组，而IL-6低于对照组（P=0.05）；观察组患者的术后疼痛数字评分法（numerical rating scale，NRS）评分显著低于对照组（P<0.05）；观察组患者术后1、3、7 d的谵妄发生率和持续时间均显著低于对照组（P<0.05）。结果表明，氢气吸入通过减轻炎症和氧化应激反应，能够降低老年胸腔镜肺癌根治患者术后谵妄发生率。

Effect of Hydrogen Inhalation on Postoperative Delirium in Patients Undergoing Radical Surgery for Lung Cancer

To investigate the effect of hydrogen inhalation on postoperative delirium in patients undergoing thoracoscopic radical surgery for lung cancer， 124 patients with thoracoscopic radical surgery for lung cancer were selected as the research subjects， and the selection period was from June 2020 to May 2021. According to the random number method， they were divided into observation group （with hydrogen inhalation of 66.7%） and control group （with oxygen inhalation of 33.3%）， with 62 cases in each group. The oxygen saturation， oxygenation index， lung dynamic compliance， interleukin （IL-6） and superoxide dismutase （SOD） were compared between the two groups at 5 min before single lung ventilation （T0） and at the end of single lung ventilation （T1）， the incidence of delirium on the 1st， 3rd， and 7th days after the operation between two groups were observed. At T0， there was no significant difference in oxygen saturation， oxygenation index， pulmonary dynamic compliance， IL-6 and SOD between the two groups （P<0.05）. At T1 time， oxygen saturation， oxygenation index， the dynamic lung compliance and SOD in the observation group was higher than the control group， while IL-6 was lower than the control group （P<0.05）. The score of numerical rating scale （NRS） was lower in the observation group than that in the control group （P<0.05）. The incidence and time of delirium on the 1st， 3rd， and 7th postoperative days in the observation group was lower than that in the control group （P<0.05）. Hydrogen inhalation is beneficial to improve the oxygenation index of patients with thoracoscopic radical surgery of lung cancer， and reduce the concentration of inflammation and the incidence of postoperative delirium.