【摘要】：目的探討兩種麻醉方法對脊柱結(jié)核患者圍術(shù)期IL-6和IL-10的影響。方法將40例行脊柱結(jié)核病灶清除術(shù)的患者隨機分入丙泊酚組和異氟烷組,每組20例。丙泊酚組在氣管插管后靜脈持續(xù)注射丙泊酚5~12mg·kg~(-1)·h~(-1)維持麻醉;異氟烷組在氣管插管后吸入異氟烷麻醉維持,維持呼氣末異氟烷濃度為1.3~1.5最低肺泡有效濃度(MAC)。分別于麻醉前即刻(T_0)、切皮后2h(T_1)、停用麻醉藥后即刻(T_2)、術(shù)后1h(T_3)、術(shù)后24h(T_4)各時間點,采集患者的中心靜脈血,采用ELISA法測定血清IL-6、IL-10水平。記錄患者的麻醉時間、術(shù)中輸液量和芬太尼用量。結(jié)果兩組間麻醉時間、術(shù)中補液量、芬太尼用量的差異均無統(tǒng)計學(xué)意義(P值均0.05)。兩組T_1時間點的血清IL-6和IL-10水平即明顯升高,之后繼續(xù)上升,丙泊酚組的血清IL-10水平至T_2時間點達峰值,兩組的血清IL-6水平和異氟烷組的血清IL-10水平均至T_3時間點達峰值,T_4時間點有所回落,但仍維持在較高水平,兩組T_1至T_4時間點的血清IL-6和IL-10水平均顯著高于同組T_0時間點(P值均0.01)。丙泊酚組T_2時間點的血清IL-6水平顯著低于異氟烷組同時間點(P0.05),T_2至T_4時間點的血清IL-10水平均顯著高于異氟烷組同時間點(P值分別0.05、0.01),兩組間其他時間點血清IL-6和IL-10水平的差異均無統(tǒng)計學(xué)意義(P值均0.05)。結(jié)論丙泊酚全憑靜脈麻醉通過調(diào)節(jié)細胞因子IL-6與IL-10的平衡,減輕手術(shù)所致的應(yīng)激反應(yīng),其效果優(yōu)于異氟烷靜吸復(fù)合麻醉。
[Abstract]:Objective to investigate the effect of two anesthetic methods on perioperative IL-6 and IL-10 in patients with spinal tuberculosis. Methods 40 patients with spinal tuberculosis were randomly divided into propofol group (n = 20) and isofluoroalkane group (n = 20). Propofol 5 ~ 12mg kg~ (- 1) h ~ (- 1) was continuously injected intravenously after endotracheal intubation in propofol group, while isohalothane group was anesthetized by inhaling isohalothane after endotracheal intubation, and the minimum alveolar effective concentration (MAC). Was maintained at 1.3 鈮，

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