Abstract: Objective: To analyze the effect of low-dose norepinephrine combined with goal-directed hemodynamic therapy (GDHT) on perioperative inflammatory response and immune status in patients undergoing lobectomy. Methods: Eighty patients who underwent lobectomy were retrospectively selected as research subjects,and were divided into the control group (n=39) and combination group (n=41) based on different fluid management programs.The control group was managed with GDHT,and the combination group was managed with low-dose norepinerine in combination with GDHT.The following indicators in the two groups were recorded:anesthesia,surgery and mechanical ventilation time;intraoperative fluid infusion volume,blood loss and urine volume;postoperative pleural volume,time of drainage tube removal,hospital stay;preoperative (T₀),immediately after intubation (T₁),immediately at the beginning of surgery (T),immediately at the end of surgery (T₃),postoperative 1 d (T₄) heart rate (HR),mean arterial pressure (MAP),use of vasoactive drugs,blood lactate concentration.The levels of peripheral blood inflammatory factors C-reactive protein (CRP),interleukin (IL)-6,IL-8,tumor necrosis factor α (TNF-α) and immune function (CD4⁺、CD8⁺、CD4⁺/CD8⁺) were compared between the two groups at T₀-T₄.The adverse reactions between the two groups were recorded. Results: There were no statistically significant differences between the combination group and the control group in terms of anesthesia duration,surgical time,or mechanical ventilation time (P>0.05).The intraoperative fluid volume in the combination group was significantly lower than that in the control group (P<0.01),while no significant differences were observed in intraoperative blood loss or urine output between the two groups (P>0.05).The MAP at T₁,T₂ and T₃ were higher in the combination group compared to the control group (P<0.05 to P<0.01),whereas there was no significant difference in HR and MAP at T₀-T₄ between the two groups (P>0.05).There was no statistically significant difference in the dosage of vasoactive drugs and blood lactate concentration between the two groups at T₀-T₄ (P>0.05).The levels of CRP,IL-6,IL-8,TNF-α and CD8⁺ in the peripheral blood of the combination group were lower those of the control group at T₄ (P<0.01).The levels of CD4⁺ and CD4⁺/CD8⁺ in the peripheral blood of the group were higher than those of the control group at T₄ (P<0.01).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions: Low-dose norepinephrine combined with GDHT reduces perioperative fluid volume,mitigates inflammatory responses,improves immune function,and may enhance postoperative recovery in lobectomy patients.