不同麻醉方法对腹腔镜结肠癌根治术患者细胞免疫及细胞因子的影响

发布时间：2018-06-25 00:27

本文选题：结肠癌 + 腹腔镜　；参考：《临床和实验医学杂志》2016年02期

【摘要】：目的探讨两种不同麻醉方法对腹腔镜结肠癌患者围术期细胞免疫及细胞因子的影响,为腹腔镜手术治疗结肠癌肿瘤提供参考。方法将64例接受腹腔镜结肠癌根治术患者将其随机分为对照组(n=32)和观察组(n=32)。对照组采用单纯全身麻醉方法,治疗组硬膜外复合静脉全身麻醉方法;记录并比较两组患者手术的手术时间、失血量、输注胶体量及术后七氟醚平均吸入浓度;检测并比较患者麻醉诱导前30 min(t1)、切皮后2h(t2)、手术结束(t3)、术后1 d(t4)、术后3 d(t5)时细胞免疫指标比及白介素6(IL-6)的含量。结果观察组七氟醚吸入浓度显著低于对照组(P0.05);观察组CD4~+、CD4~+/CD8~+在t2~t5显著低于t1时(P0.05);观察组CD3~+、CD4~+、CD4~+/CD8~+在t2~t5水平均高于对照组,且CD3~+、CD4~+在T4水平显著高于对照组(P0.05);且CD4~+/CD8~+在t5水平显著高于对照组(P0.05);两组CD8~+、NK细胞水平在t1~t5对比均无显著性差异(P0.05);两组患者IL-6在t2~t5时水平显著高于t1时(P0.05);观察组IL-6在t2~t4时水平显著低于对照组t2~t4时(P0.05)。结论腹腔镜结肠癌手术采用两种不同麻醉方法对患者围术期细胞免疫有一定的抑制作用。与单纯全身麻醉相比,硬膜外复合静脉全身麻醉对患者细胞免疫及IL-6变化影响较小。
[Abstract]:Objective to investigate the effects of two different anesthetic methods on perioperative cellular immunity and cytokines in patients with laparoscopic colon cancer and to provide reference for laparoscopic treatment of colon cancer. Methods 64 patients undergoing laparoscopic radical resection of colon cancer were randomly divided into two groups: control group (n = 32) and observation group (n = 32). The patients in the control group were treated with simple general anesthesia, and the patients in the treatment group were treated with epidural combined intravenous general anesthesia, the operation time, blood loss, infusion colloid volume and the mean inhalation concentration of sevoflurane were recorded and compared between the two groups. The cellular immunity index ratio and interleukin-6 (IL-6) content were measured at 30 min (T1) before anesthesia induction, 2 h after skin incision (T2), 1 day after operation (T2), 1 day after operation (t4) and 3 days after operation (T5). Results the concentration of sevoflurane inhalation in the observation group was significantly lower than that in the control group (P0.05), and the levels of CD4 ~ / CD8 ~ in the observation group were significantly lower than those in the control group (P0.05), and the levels of CD3 ~ + CD4 ~ + CD4- / CD8 ~ in the observation group were higher than those in the control group. The level of CD3 ~ + CD4 ~ + in T4 was significantly higher than that in control group (P0.05), and the level of CD4 ~ / CD8 ~ + in T5 was significantly higher than that in control group (P0.05). There was no significant difference in the level of CD8 ~ + NK cells in t1~t5 between the two groups (P0.05); the level of IL-6 in t2~t5 was significantly higher in two groups than in T1 group (P0.05). The level of IL-6 at t2~t4 was significantly lower than that at t2~t4 in control group (P0.05). Conclusion Laparoscopic colon cancer surgery with two different anesthetic methods has a certain inhibition effect on perioperative cellular immunity. Compared with general anesthesia alone, epidural combined intravenous general anesthesia had little effect on cellular immunity and IL-6 changes.
【作者单位】：湖北民族学院附属民大医院麻醉科;
【分类号】：R614;R735.35

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