两种麻醉方法对原发性肝癌围手术期免疫学指标的影响

发布时间：2018-05-20 16:09

  本文选题：原发性肝癌 + 炎症因子　； 参考：《中国免疫学杂志》2016年03期

【摘要】：目的:探讨两种麻醉方法对原发性肝癌患者围手术期免疫学相关指标的影响。方法:选择原发性肝癌患者60例,肝功能Child-Pugh分级为A~B级,随机分为两组,异丙酚全凭静脉麻醉组30例(A组),七氟醚静吸复合麻醉组30例(B组),分别记录麻醉前30 min(T0)、术毕(T1)、术后24 h(T2)静脉血中CD3~+、CD4~+、CD8~+、CD4~+/CD8~+及TNF-α、IL-2、IL-6的水平。结果:A、B两组患者围手术期生理指标MAP、HR、SpO_2、RR各时点均无明显差异(P0.05);麻醉前A、B两组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+均无显著性变化(P0.05),两组CD3~+、CD8~+在各时点均未发生显著性变化(P0.05)。与T0相比,T1时点A、B两组CD4~+、CD4~+/CD8~+均降低(P0.05),但B组T2时点与T0时点比较无显著性差异。在T1、T2时点B组CD4~+、CD4~+/CD8~+均比A组明显升高(P0.05)。与T0时点相比,A组和B组患者在T1、T2时点IL-6水平明显升高(P0.05),各时点A组和B组间差异无统计学意义(P0.05)。与T0时点相比,A组TNF-α水平无显著变化(P0.05),B组术后一天明显升高(P0.05)。IL-2在各时点两组间均无显著性变化(P0.05)。结论:异丙酚全凭静脉麻醉和七氟醚静吸复合麻醉均会对肝癌患者的免疫功能产生抑制作用,使用七氟醚静吸复合麻醉组对患者免疫功能影响较小。
[Abstract]:Objective: to investigate the effect of two anesthetic methods on immunological parameters in patients with primary liver cancer during perioperative period. Methods: sixty patients with primary liver cancer were randomly divided into two groups. The liver function was classified as Agna B grade by Child-Pugh. Propofol total intravenous anesthesia group (n = 30), sevoflurane combined anesthesia group (n = 30), group B (n = 30). The levels of CD3 ~ + CD4 ~ + CD8 ~ / CD8 ~ + and TNF- 伪 -IL-2IL-6 in venous blood were recorded 30 min before anesthesia, 30 min after operation and 24 h after operation. Results there was no significant difference between the two groups in the perioperative physiological index MAPP / HRO _ (2) RR at each time point (P 0.05), but before anesthesia, there was no significant change in CD3 ~ (4 ~ +) CD _ (8) ~ / CD _ (8) ~ (8 ~) in the two groups (P 0.05), and no significant change was found in each time point in the two groups (P _ (0.05). Compared with T0, the levels of CD4 ~ / CD4 ~ / CD8 ~ in T _ 1 / T _ 2 group were lower than those in T _ 0 group, but there was no significant difference between T _ 2 time point and T _ 0 time point in B group. At T _ 1 T _ 2, the levels of CD _ 4 ~ / CD _ 4 ~ / CD _ 8 ~ in group B were significantly higher than those in group A (P 0.05). The level of IL-6 in group A and group B was significantly higher than that in group A and group B at T _ 1 / T _ 2, and there was no significant difference between group A and group B at T _ 1 and T _ 2, and there was no significant difference between group A and group B at T _ 1 and T _ 2. There was no significant change in TNF- 伪 level in group A compared with that at time point T0. The level of TNF- 伪 in group A was significantly higher than that in group B on the first day after operation. There was no significant change in IL-2 between the two groups at each time point (P 0.05). Conclusion: propofol total intravenous anesthesia and sevoflurane combined anesthesia can inhibit the immune function of patients with liver cancer, but sevoflurane combined anesthesia group has little effect on immune function.
【作者单位】： 唐山市工人医院麻醉科;唐山市工人医院神内二科;唐山市工人医院神经外科;
【分类号】：R614.2;R735.7
，

本文编号：1915342