允许性高碳酸血症对腹腔镜全子宫切除术患者IL-6、IL-10和TNF-α的影响

发布时间：2018-05-07 22:18

本文选题：麻醉 + 高碳酸血症　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的探讨允许性高碳酸血症对腹腔镜全子宫切除手术的应用价值及对患者IL-6、IL-10及TNF-a的影响。方法将46例择期行腹腔镜全子宫切除术患者随机分为对照组(C组,23例)和允许性高碳酸血症组(P组,23例)。两组全麻诱导后,通过动脉血气结果调整机械通气参数,P组PaCO2维持在45～60mmHg,pH值维持在7.25-7.35之间；对照组维持PaCO2维持在35～45mmHg,pH值维持在7.35-7.45之间。记录To(麻醉前)、T1(麻醉诱导后)、T2(气腹0.5小时)、T3(气腹1小时)、T4(气腹2小时)、T5(结束气腹0.5小时)、T6(结束气腹1小时)时间点血压、心率、血气分析,并测定IL-6、IL-10及TNF-α浓度。结果两组病人年龄、体重、气腹时间、手术时间及拔管时间比较无统计学意义(P0.05)；C组在T5、T6时点的平均动脉压明显比P组高,差异有统计学意义(P0.05),P组T2时点的心率较P组高,差异有统计学意义(P0.05)；P组T2～T6时IL-6和TNF-α均低于对照组,差异有统计学意义(P0.05或P0.01),两组IL-10差异无统计学意义(P0.05)。结论允许性高碳酸血症下行腹腔镜全子宫切除术,IL-6、 TNF-α均低于正常通气组,提示这种通气方式可能适合此类手术的麻醉维持。
[Abstract]:Objective to investigate the value of permissive hypercapnia in laparoscopic hysterectomy and its effect on IL-6 IL-10 and TNF-a. Methods 46 patients undergoing laparoscopic hysterectomy were randomly divided into control group (n = 23) and permitted hypercapnia group (n = 23). After induction of general anesthesia, the parameters of mechanical ventilation were adjusted by arterial blood gas. The pH value of PaCO2 in group P was maintained between 7.25 and 7.35 in group P and the pH value of PaCO2 in control group was between 7.35 and 7.45 mm. The blood pressure, heart rate and blood gas were recorded at the time point of ToT _ 1 (after induction of anesthesia), and the concentrations of IL-10 and TNF- 伪 were measured. Results there was no significant difference in age, body weight, pneumoperitoneum time, operation time and extubation time between the two groups. The mean arterial pressure at T5 / T6 in group C was significantly higher than that in group P, and the heart rate in group P was significantly higher than that in group P at T2. The difference of IL-6 and TNF- 伪 in T2~T6 group was significantly lower than that in control group (P 0.05 or P 0.01). There was no significant difference in IL-10 between the two groups (P 0.05). Conclusion the levels of IL-6 and TNF- 伪 in laparoscopic total hysterectomy under permissive hypercapnia are lower than those in normal ventilation group, suggesting that this ventilation may be suitable for anesthesia maintenance.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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