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insertion of the double-lumen tracheal tube，group L was given aerosol inhalation of Lidocaine hydrochloride injection 1.5 mg/kg
diluted to 20 mL with sterile water；group N was given aerosol inhalation of sterile water 20 mL at the flow rate of 2 L/min.
Patients in both groups were continuously pumped with Propofol injectable emulsion 4-12 mg/（kg·h）+Remifentanil hydrochloride
for injection 0.2-1 μg/（kg·min）+Cisatracurium besilate for injection 0.05-0.1 mg/（kg·h）for anesthesia maintenance. Eight hours
after operation，group L inhaled of Lidocaine hydrochloride injection 1.5 mg/kg diluted to 20 mL with sterile water again，and
group N inhaled of sterile water 20 mL again. Arterial blood gas analysis indexes [arterial partial pressure of oxygen（PaO2 ），partial
pressure of carbon dioxide （PaCO2 ），lactic acid （Lac），oxygenation index （P/F）]，serum inflammatory factors [interleukin 6
（IL-6），tumor necrosis factor α（TNF-α）and nuclear factor κB（NF-κB）] were observed in 2 groups before anesthesia（T 1 ），60
min of one-lung ventilation（T 2 ），and 12 h after extubation（T 3 ）. Respiratory and circulatory parameters [extravascular lung
water（EVLW），pulmonary vascular permeability index（PVPI），heart rate（HR），stroke volume（SV）] were also observed 5 min
after anesthesia （t1 ），T2 and 15 min after surgery （t3 ）. Extubation time，visual analogue scale （VAS） score of 12 h after
extubation，time of getting out of bed，the incidence of throat pain of 12 h after extubation and the occurrence of ADR were
recorded in 2 groups. RESULTS：There was no significant difference in arterial blood gas analysis indexes，serum inflammatory
factor levels，respiratory and circulatory parameters between the two groups at T1 or t1（P＞0.05）. The levels of PaO2，PaCO2，
Lac，IL-6，TNF-α and NF-κB in 2 groups at T2 and T3 were significantly higher than at T1，P/F at T2 and T3 was significantly lower
than at T1；in group L，the levels of PaCO2，Lac，IL-6，TNF-α，NF-κB were significantly lower than group N，and PaO2 and P/F
were significantly higher than group N（P＜0.05）. EVLW and PVPI of 2 groups at T2 and t3，SV of group L，HR of group N were
significantly higher than corresponding group at T1，while EVLW，PVPI and HR of group L were significantly lower than group
N，SV was significantly higher than group N at corresponding period（P＜0.05）. The extubation time，VAS score of 12 h after
extubation，time to get out of bed after surgery，the incidence of throat pain of 12 h after extubation in group L were significantly
shorter or lower than group N（P＜0.05）. No obvious and serious ADR occurred during recovery. CONCLUSIONS：Lidocaine
aerosol inhalation can effectively improve ventilation and oxygenation function of patients undergoing one-lung ventilation，inhibit
the release of inflammatory factors，and reduce the incidence of postoperative complications with good safety.
KEYWORDS Lidocaine；Aerosol inhalation；One-lung ventilation；Postoperative period；Pulmonary function；Inflammatory
factors；Complication

单肺通气（one-lung ventilation，OLV）主要用于胸科 或肺泡，使药物持续作用于肺泡上皮或血管内皮等靶器
手术，是一种能为外科医师提供足够视野及操作空间， 官，从而达到治疗呼吸道疾病的目的的一种给药方式。
同时将两肺充分隔离以防止交叉感染或降低肺部肿瘤 由于雾化吸入的作用位置较集中、作用时间亦相对可
[8]
种植传播风险的麻醉技术。但在临床应用中发现，该技 控，因此可减轻药物对全身组织器官功能的影响 。目
术可引发急性肺损伤（包括呼吸机相关性肺损伤）、术后 前，虽然已有研究将雾化吸入利多卡因用于外科手术

肺部炎症、低氧血症以及因肺缺血再灌注损伤所导致的 （如耳鼻喉科手术、双腔支气管插管及甲状腺术）麻
[1]
急性呼吸窘迫综合征等并发症 。 醉 [9－11] ，但用于 OLV 患者的报道甚少。为此，本研究探
利多卡因作为钠离子通道阻滞药，不仅具有局部神 讨了利多卡因雾化吸入对 OLV 患者肺功能及炎症因子
经阻滞（局部麻醉）的作用，而且还具有抗心律失常的活 的影响，旨在为临床用药提供参考。
[2]
性，同时该药也是一种膜稳定剂 。有研究表明，利多卡 1 资料与方法
因能通过抑制炎症反应来改善OLV患者的肺部损伤，具 1.1 纳入与排除标准
有类似抗炎剂的作用 。静脉注射利多卡因可减轻胸科 纳入标准包括：（1）美国麻醉医师协会分级Ⅰ～Ⅱ
[3]
手术患者术后疼痛程度、降低术后肺部并发症的发生风 级；（2）术前未接受放化疗及激素疗法等治疗手段；（3）
险、抑制机体炎症反应，具有减轻肺损伤的作用 [4－5] ，但 无明显肝肾功能异常；（4）美国纽约心脏病学会心功能
由于该药静脉使用易出现中毒反应，如嗜睡、口周麻木、 分级Ⅰ～Ⅱ级，心脏节律无明显异常；（5）术前无肺部感
耳鸣震颤等，若用药不当则可致血药浓度过高，从而引 染或感染经治愈后1周以上；（6）肺功能正常或轻度通气
起严重心律失常，甚至心脏骤停 [2，4] ，因此其临床应用受 功能障碍；（7）具有完全自主决策能力，拟在胸腔镜下行
到了一定的限制 [6－7] 。 肺部分切除术的患者。
雾化吸入是通过特定装置利用高速气体将药物转 排除标准包括：（1）合并糖尿病、高血压等慢性病且
化为气溶胶颗粒的形式，经上下呼吸道送至各级支气管 未经规范治疗者；（2）房室传导阻滞、左右束支传导异常

中国药房 2021年第32卷第18期 China Pharmacy 2021 Vol. 32 No. 18 ·2255 ·