利多卡因对腹腔镜结直肠癌根治术患者血清白细胞介素10和细胞角蛋白20的影响

发布时间：2018-04-17 12:38

本文选题：利多卡因 + 结直肠癌根治术　；参考：《临床麻醉学杂志》2015年04期

【摘要】：目的观察术中静脉输注利多卡因对腹腔镜结直肠癌根治术后血清白细胞介素(IL)-10和细胞角蛋白(CK)20的影响。方法择期行腹腔镜结直肠癌根治术患者60例,年龄30~70岁,采用随机数字表法均分为利多卡因组(L组)和对照组(C组),每组30例。麻醉诱导时L组以利多卡因首剂1mg/kg静脉注射,继以利多卡因1.5mg·kg-1·h-1持续泵注直至手术结束,C组持续输注等量生理盐水。于麻醉诱导前5min(T1)、手术结束即刻(T2)、术后24h(T3)和48h(T4)从上臂外周静脉采集血液标本,采用ELISA法检测血清IL-10浓度;采用RT-PCR法检测CK20mRNA。结果 T2~T4时两组患者血清IL-10浓度均明显高于T1时(P0.05)。T3时L组血清IL-10浓度明显低于C组(P0.05)。T1、T2、T4时两组患者血清IL-10浓度差异均无统计学意义。T1、T3时两组患者CK20mRNA阳性表达率差异均无统计学意义。结论利多卡因可降低腹腔镜结直肠癌根治术患者术后血清IL-10浓度,有利于减轻术后免疫抑制,但可能对术后癌细胞血行微转移无明显影响。
[Abstract]:Objective to observe the effect of intraoperative intravenous infusion of lidocaine on serum interleukin-10 (IL-10) and cytokeratin (CK-20) after laparoscopic radical resection of colorectal cancer.Methods A total of 60 patients, aged 30 to 70 years, undergoing laparoscopic radical resection of colorectal cancer were randomly divided into two groups: lidocaine group (group L) and control group (group C (n = 30).During anesthesia induction, the first dose of 1mg/kg in group L was injected intravenously, followed by continuous infusion of 1.5mg kg-1 h-1 until the end of operation.The blood samples were collected from the peripheral veins of the upper arm 5 minutes before anesthesia induction, and the serum IL-10 concentration was detected by ELISA method and CK20mRNA by RT-PCR method. The blood samples were collected from the peripheral veins of the upper arm 5 min before anesthesia induction, and 24 h after operation, 24 h after operation, 24 h after operation, and 48 h after the operation, the blood samples were collected from the peripheral veins of the upper arm.Results the serum IL-10 concentration in T2~T4 group was significantly higher than that in T 1 group P 0.05U. T3 group L was significantly lower than that in C group P0.05U. T1 + T 2 + T 4 group. There was no significant difference in serum IL-10 concentration between the two groups. The positive expression rate of CK20mRNA in T 1 T 3 group was higher than that in T 1 T 3 group.There was no statistical significance.Conclusion Lidocaine can reduce the concentration of serum IL-10 in patients undergoing laparoscopic radical resection of colorectal cancer, which is helpful to alleviate the postoperative immunosuppression, but it may have no effect on the micrometastasis of cancer cells after operation.
【作者单位】：南昌大学第一附属医院麻醉科;赣州市人民医院麻醉科;江西省儿童医院麻醉科;
【基金】：江西省卫计委科技计划课题(20143069)
【分类号】：R735.34;R614

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