中文摘要：

目的观察奥曲肽对肝叶切除术患者围术期血浆肿瘤坏死因子-α（tumournecYo$i8factoralpha，TNF-α）、白细胞介素-6（interleukin6，IL-6）、肺表面活性物质相关蛋白D（surfaetantproteinD，SP-D）、氧合指数（oxygenationindex，OI）和呼吸指数（respiratoryindex，RI）的影响，探讨奥曲肽对肝癌患者肝叶切除术围术期肺损伤的保护效应及可能机制。方法选择2013年2—12月于西南医院肝胆外科择期行肝叶切除术的肝癌患者40例，ASAⅡ～Ⅲ级，随机分为对照组或奥曲肽组，每组20例。2组患者均采用相同的麻醉方法。奥曲肽组在麻醉诱导后静脉注射奥曲肽0．1mg，然后0．5mg溶于60mL氯化钠注射液中泵注至手术结束前30min停止；对照组予等容量氯化钠注射液泵注。监测并对比分析麻醉诱导前（T0）、切皮后10min（T1）、解除阻断恢复肝血流后30min（T2）、术后1h（T3）、术后24h（T4）桡动脉血血气分析结果，计算0I值和RI值；于T0、T1、T2、T4时检测TNF--α、IL-6和sP-D浓度。结果两组组内各时相点与麻醉诱导前（Tn）相比，T2～T4时两组TNF-α、IL-6、SP-D的含量和RI值均显著升高（P〈0．05）；而0I值显著降低（P〈0．05）。两组组间各时相点同时值比较，T2-T4三个时相点奥曲肽组TNF-α、IL-6、SP-D的含量和RI值均低于对照组，而0I值高于对照组，差异均有统计学意义（P〈0．05）。结论奥曲肽能够抑制肝叶切除术患者围术期炎性反应，减轻肺损伤，并由此降低手术对肺功能的影响。

英文摘要：

Objective To investigate the effects of octreotide on tumour necrosis factor alpha （TNF-α）, interleukin 6 （IL-6）, surfactant protein D （SP-D）, oxygenation index （OI） and respiratory index （RI） in patients during peri-operative period of hepatic lobectomy. Methods Forty ASA Ⅱ or m patients scheduled for hepatic lobectomy in Southwest hospital from February to December 2013 were enrolled in this study. Then they were randomly divided into octreotide group and control （n=20 ）. The same standard anesthesia protocol was used for induction and maintenance in all 2 groups. After anesthesia induction, the octreotide group was given 0.1 mg octreotide intravenously followed by 0.5 mg/60 mL by pain pump until the end of the surgery. While the patients of control were given same volume of normal saline through same approach. Arterial blood samples were collected for blood gas analysis before induction of anesthesia （To ）, 10 min after cutting skin （T1 ）, 30 min after recuperating liver blood flow （T2 ）, and 1 （T3 ） and 24 h （T4 ） after operation. OI and RI were calculated. Plasma TNF-α, IL-6 and SP-D were measured at To, T1, T2, T3 and T4. Results Compared with To, the plasma levels of TNF-α, IL-6 and SP-D and RI were significantly increased, while the OI was significantly decreased at T2 to T4 in the 2 groups （P 〈 0.05 ）. The plasma level of TNF-α, IL-6 and SP-D and RI in the octreotide group were significantly lower, while the OI was obviously higher than those in the control group at T2 to T4 （ P 〈 0.05 ）. Conclusion Octreotide attenuates the lunginjury and protects lung function induced by hepatic lobectomy, which probably through inhibiting inflammatory response.