本文選題：利多卡因 + 結(jié)直腸癌根治術(shù)　； 參考：《臨床麻醉學(xué)雜志》2015年04期

【摘要】：目的觀察術(shù)中靜脈輸注利多卡因?qū)Ω骨荤R結(jié)直腸癌根治術(shù)后血清白細(xì)胞介素(IL)-10和細(xì)胞角蛋白(CK)20的影響。方法擇期行腹腔鏡結(jié)直腸癌根治術(shù)患者60例,年齡30~70歲,采用隨機數(shù)字表法均分為利多卡因組(L組)和對照組(C組),每組30例。麻醉誘導(dǎo)時L組以利多卡因首劑1mg/kg靜脈注射,繼以利多卡因1.5mg·kg-1·h-1持續(xù)泵注直至手術(shù)結(jié)束,C組持續(xù)輸注等量生理鹽水。于麻醉誘導(dǎo)前5min(T1)、手術(shù)結(jié)束即刻(T2)、術(shù)后24h(T3)和48h(T4)從上臂外周靜脈采集血液標(biāo)本,采用ELISA法檢測血清IL-10濃度;采用RT-PCR法檢測CK20mRNA。結(jié)果 T2~T4時兩組患者血清IL-10濃度均明顯高于T1時(P0.05)。T3時L組血清IL-10濃度明顯低于C組(P0.05)。T1、T2、T4時兩組患者血清IL-10濃度差異均無統(tǒng)計學(xué)意義。T1、T3時兩組患者CK20mRNA陽性表達(dá)率差異均無統(tǒng)計學(xué)意義。結(jié)論利多卡因可降低腹腔鏡結(jié)直腸癌根治術(shù)患者術(shù)后血清IL-10濃度,有利于減輕術(shù)后免疫抑制,但可能對術(shù)后癌細(xì)胞血行微轉(zhuǎn)移無明顯影響。
[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.
【作者單位】： 南昌大學(xué)第一附屬醫(yī)院麻醉科;贛州市人民醫(yī)院麻醉科;江西省兒童醫(yī)院麻醉科;
【基金】：江西省衛(wèi)計委科技計劃課題(20143069)
【分類號】：R735.34;R614

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