不同麻醉方式对直肠癌患者围手术期细胞免疫功能的影响

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目的探讨不同麻醉方式对直肠癌患者围手术期细胞免疫功能的影响。方法选取2011年9月至2013年9月间行直肠癌根治术的72例患者,按照随机数字表法分为观察组和对照组,每组36例。观察组患者给予靶控输注静脉麻醉,对照组患者给予腰硬联合麻醉。观察两组患者的围手术期细胞免疫功能变化情况。结果观察组患者的手术时间长于对照组,术中出血量少于对照组,但差异均无统计学意义(均P>0.05)。两组患者的各项免疫球蛋白水平指标比较,差异均无统计学意义(均P>0.05)。与麻醉前比较,麻醉时、手术结束时及手术后两组患者的白介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平以及CD3、CD4 T细胞亚群水平均出现明显变化,且观察组的变化幅度明显大于对照组,差异均有统计学意义(均P<0.05)。结论靶控输注静脉麻醉和腰硬联合麻醉均会对直肠癌根治术患者的围手术期细胞免疫功能产生抑制,且靶控输注静脉麻醉的抑制作用更明显。 Objective To investigate the effects of different anesthesia on cellular immune function in patients with rectal cancer during perioperative period. Methods Seventy-two patients undergoing radical resection of rectal cancer between September 2011 and September 2013 were divided into observation group and control group according to the random number table method, with 36 cases in each group. Patients in the observation group were given target-controlled infusion of intravenous anesthesia while patients in the control group were given combined spinal and epidural anesthesia. Perioperative cellular immune function changes in two groups were observed. Results The operation time of the observation group was longer than that of the control group. The blood loss in the observation group was less than that of the control group, but the difference was not statistically significant (all P> 0.05). There was no significant difference between the two groups in the immunoglobulin levels (all P> 0.05). Compared with those before anesthesia, the levels of IL-6 and TNF-α and the levels of CD3 and CD4 T cells in the two groups after anesthesia, surgery and surgery were significantly changed, The change range of the observation group was obviously larger than that of the control group (all P <0.05). Conclusion Both target-controlled infusion of intravenous anesthesia and combined spinal and epidural anesthesia can inhibit perioperative cellular immune function in patients undergoing radical resection of rectal cancer, and target-controlled infusion of venous anesthesia is more effective.
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