本文選題：原發(fā)性肝癌 + 炎癥因子　； 參考：《中國免疫學雜志》2016年03期

【摘要】：目的:探討兩種麻醉方法對原發(fā)性肝癌患者圍手術期免疫學相關指標的影響。方法:選擇原發(fā)性肝癌患者60例,肝功能Child-Pugh分級為A~B級,隨機分為兩組,異丙酚全憑靜脈麻醉組30例(A組),七氟醚靜吸復合麻醉組30例(B組),分別記錄麻醉前30 min(T0)、術畢(T1)、術后24 h(T2)靜脈血中CD3~+、CD4~+、CD8~+、CD4~+/CD8~+及TNF-α、IL-2、IL-6的水平。結果:A、B兩組患者圍手術期生理指標MAP、HR、SpO_2、RR各時點均無明顯差異(P0.05);麻醉前A、B兩組CD3~+、CD4~+、CD8~+、CD4~+/CD8~+均無顯著性變化(P0.05),兩組CD3~+、CD8~+在各時點均未發(fā)生顯著性變化(P0.05)。與T0相比,T1時點A、B兩組CD4~+、CD4~+/CD8~+均降低(P0.05),但B組T2時點與T0時點比較無顯著性差異。在T1、T2時點B組CD4~+、CD4~+/CD8~+均比A組明顯升高(P0.05)。與T0時點相比,A組和B組患者在T1、T2時點IL-6水平明顯升高(P0.05),各時點A組和B組間差異無統(tǒng)計學意義(P0.05)。與T0時點相比,A組TNF-α水平無顯著變化(P0.05),B組術后一天明顯升高(P0.05)。IL-2在各時點兩組間均無顯著性變化(P0.05)。結論:異丙酚全憑靜脈麻醉和七氟醚靜吸復合麻醉均會對肝癌患者的免疫功能產(chǎn)生抑制作用,使用七氟醚靜吸復合麻醉組對患者免疫功能影響較小。
[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- 偽 -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- 偽 level in group A compared with that at time point T0. The level of TNF- 偽 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.
【作者單位】： 唐山市工人醫(yī)院麻醉科;唐山市工人醫(yī)院神內(nèi)二科;唐山市工人醫(yī)院神經(jīng)外科;
【分類號】：R614.2;R735.7
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本文編號：1915342