本文選題：結(jié)腸癌 + 腹腔鏡��； 參考：《臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志》2016年02期

【摘要】：目的探討兩種不同麻醉方法對(duì)腹腔鏡結(jié)腸癌患者圍術(shù)期細(xì)胞免疫及細(xì)胞因子的影響,為腹腔鏡手術(shù)治療結(jié)腸癌腫瘤提供參考。方法將64例接受腹腔鏡結(jié)腸癌根治術(shù)患者將其隨機(jī)分為對(duì)照組(n=32)和觀察組(n=32)。對(duì)照組采用單純?nèi)砺樽矸椒?治療組硬膜外復(fù)合靜脈全身麻醉方法;記錄并比較兩組患者手術(shù)的手術(shù)時(shí)間、失血量、輸注膠體量及術(shù)后七氟醚平均吸入濃度;檢測(cè)并比較患者麻醉誘導(dǎo)前30 min(t1)、切皮后2h(t2)、手術(shù)結(jié)束(t3)、術(shù)后1 d(t4)、術(shù)后3 d(t5)時(shí)細(xì)胞免疫指標(biāo)比及白介素6(IL-6)的含量。結(jié)果觀察組七氟醚吸入濃度顯著低于對(duì)照組(P0.05);觀察組CD4~+、CD4~+/CD8~+在t2~t5顯著低于t1時(shí)(P0.05);觀察組CD3~+、CD4~+、CD4~+/CD8~+在t2~t5水平均高于對(duì)照組,且CD3~+、CD4~+在T4水平顯著高于對(duì)照組(P0.05);且CD4~+/CD8~+在t5水平顯著高于對(duì)照組(P0.05);兩組CD8~+、NK細(xì)胞水平在t1~t5對(duì)比均無(wú)顯著性差異(P0.05);兩組患者IL-6在t2~t5時(shí)水平顯著高于t1時(shí)(P0.05);觀察組IL-6在t2~t4時(shí)水平顯著低于對(duì)照組t2~t4時(shí)(P0.05)。結(jié)論腹腔鏡結(jié)腸癌手術(shù)采用兩種不同麻醉方法對(duì)患者圍術(shù)期細(xì)胞免疫有一定的抑制作用。與單純?nèi)砺樽硐啾?硬膜外復(fù)合靜脈全身麻醉對(duì)患者細(xì)胞免疫及IL-6變化影響較小。
[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.
【作者單位】： 湖北民族學(xué)院附屬民大醫(yī)院麻醉科;
【分類號(hào)】：R614;R735.35

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