静吸复合麻醉与单纯静脉麻醉对胃癌手术应激反应及细胞
免疫功能的影响
郑仲磊;范晓英
【期刊名称】《中国现代普通外科进展》 【年(卷),期】2017(020)009
【摘要】Objective:To explore the analysis of the static absorption compound anesthesia with intravenous anesthesia alone stress reaction and cellular immune function in patients with gastric cancer surgery.Methods:From March 2014 to March 2014 were lines of gastric cancer patients,78 cases of elective surgical procedureS,using the random number table method was divided into control group and experimental group,each group of 39 cases,control group given simple intravenous anesthesia,patients given static absorption compound anesthesia,compared two groups of patients with preoperative 30 min (T0),cut the skin (T1),bi (T2),tube drawing immediate (T3),24 h after surgery (T4) different time points,such as serum C-reactive protein (CRP) and interleukin 2 (IL-2),the level of interleukin 8 (IL-8),CD4,CD8,the number of NK cells,and CD4/CD8 ratio.Re· sults:T2 IL-2,IL-8 point test group dropped to the lowest level,CRP rose to the highest,to T4 point back to the level before anesthesia,IL-2 and the control group,while the level of IL-8 T3 point minimum,CRP rose to the highest,and T4 point is still not fully recovered to the level before anesthesia,CRP T1 and T4
each point test group,IL-2 and IL-8 cytokine levels were significantly better than the control group,with significant difference (P＜0.05).T1 point,two groups of patients with CD4,NK cells and CD4/CD8 ratios were significantly decreased,CD8 levels increased significantly,CD4 T3 point test group began to rebound,NK cells and CD4/CD8 ratio,level of CD8 began to decline,and T4 point before anesthesia recovery level,and T4 point control indicators are still relatively preoperative levels have obvious deviation,T1 and T4 each point group CD4,NK cells and CD4/CD8 ratio than the control group obviously on the higher side,had clear statistical significance(P＜0.05),and each point CD8 levels have no obvious difference between groups(P＞0.05).Conelusions:Different anesthetic methods on gastric cancer surgery the patient's level of stress reaction and cell immune function all can produce certain effect,compared
with
the
conventional
simple
intravenous
anesthesia,the static absorption compound anesthesia can obviously relieve open perioperative stress response in patients with gastric cancer,reduce the inhibition of cellular immune level,is a kind of can effectively guarantee the anesthesia effect and prognosis of patients with ideal anesthesia method.%目的:分析静吸复合麻醉与单纯静脉麻醉对胃癌手术患者应激反应及细胞免疫功能的影响.方法:选取2014年3月-2016年3月收治的胃癌行择期手术患者78例,采用随机数字表法分为对照组与试验组,每组各39例,对照组给予单纯静脉麻醉,试验组给予静吸复合麻醉,对比两组患者术
前30min (T0)、切皮时(T1)、术毕(T2)、拔管即刻(T3)、术后24 h (T4)等不同时相点血清C-反应蛋白(CRP)、白细胞介素-2(IL-2)、白细胞介素-8(IL-8)水平,CD4、CD8、NK细胞数以及CD4/CD8比值.结果:T2时相点试验组IL-2、IL-8水平降至最低(P＜0.05),CRP升至最高(P＜0.05),至T4时相点恢复至麻醉前水平(P＞0.05),而对照组IL-2、IL-8水平则在T3时相点降至最低(P＜0.05),CRP升至最高(P＜0.05),至T4时相点仍未完全恢复至麻醉前水平(P＜0.05),T1～T4各时相点试验组CRP、IL-2、IL-8等细胞因子水平均明显优于对照组,差异有统计学意义(P＜0.05).T1时相点,两组患者的CD4、NK细胞及CD4/CD8比值均明显下降(P＜0.05),CD8水平明显升高(P＜0.05).试验组T3时相点CD4、NK细胞及CD4/CD8比值处于最低点,随后开始回升(P＜0.05);CD8水平最高值,并随后开始下降(P＜0.05);至T4时相点恢复至麻醉前水平(P＞0.05).而对照组T4时相点各项指标仍较术前水平有明显偏差(P＜0.05),T1～T4各时相点试验组CD4、NK细胞及CD4/CD8比值较对照组明显偏高,差异有统计学意义(P＜0.05),组间各时相点CD8水平无明显差异(P＞0.05).结论:不同麻醉方式对胃癌开腹手术患者的应激反应水平和细胞免疫功能均可产生一定的影响,相较于常规的单纯静脉麻醉,静吸复合麻醉可明显缓解胃癌开腹患者的围手术期应激反应水平,减轻术后细胞免疫的抑制程度,是一种可有效保证麻醉效果和患者预后的理想麻醉方法. 【总页数】4页(692-695)
【关键词】静吸复合麻醉;单纯静脉麻醉;胃肿瘤;开腹手术;应激反应;细胞免疫功能
【作者】郑仲磊;范晓英
静吸复合麻醉与单纯静脉麻醉对胃癌手术应激反应及细胞免疫功能的影响
