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目的研究麻醉方法对腹腔镜下子宫次切术患者免疫功能和肿瘤转移的影响。方法选取80例行腹腔镜下子宫次全切除术患者作为研究对象。按随机数字表法分为观察组和对照组,观察组采用全凭静脉麻醉,对照组采用全麻联合硬膜外阻滞,观察两组患者术前(T0)、术毕(T1)、术后24 h(T2)、术后48 h(T3)的一般生理指标、T淋巴细胞亚群、免疫球蛋白水平、不良反应等情况。结果观察组与对照组的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、氧饱和度(Sp O_2)在术前(T0)、术毕(T1)、术后24 h(T2)、术后48 h(T3)各时点比较差异均无统计学意义(P>0.05);观察组和对照组CD3、CD4、CD8在T1、T2时点较T0时点降低,但观察组降低更明显(P<0.05);观察组和对照组免疫球蛋白指标Ig G、Ig A、Ig M在T0、T1、T2、T3各时点比较差异均无统计学意义(P>0.05);组内CRO-1、IP-10水平T1、T2时比T0时降低(P<0.05);观察组不良情况总发生率(7.50%)小于对照组(22.50%),差异具有统计学意义(P<0.05)。结论全凭静脉麻醉和全麻联合硬膜外阻滞麻醉均会对患者免疫功能产生抑制作用,但不会造成患者的肿瘤转移,临床上采取全凭静脉麻醉治疗效果更显著。
Objective To study the effects of anesthesia on immune function and tumor metastasis in patients undergoing laparoscopic hysterectomy. Methods Totally 80 cases underwent hysteroscopic hysterectomy were studied. According to random number table, the patients were divided into observation group and control group. The observation group was treated with total intravenous anesthesia. The control group was treated with general anesthesia combined with epidural block. The T0, T1, After 24 h (T2), 48 h (T3) after the general physiological indicators, T lymphocyte subsets, immunoglobulin levels, adverse reactions and so on. Results The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and oxygen saturation (Sp O_2) in observation group and control group were significantly higher than those in control group at T0, T2, and 48 h after operation (P> 0.05). The CD3, CD4 and CD8 of the observation group and the control group were lower than those at the T1, T2, (P <0.05). There was no significant difference in immunoglobulin Ig G, Ig A and Ig M between the observation group and the control group at T0, T1, T2 and T3 (P> 0.05) ; The levels of CRO-1 and IP-10 in group C were lower than those in T0 at T1 and T2 (P <0.05); the incidence of adverse cases in observation group (7.50%) was less than that in control group (22.50% P <0.05). Conclusion All intravenous anesthesia and general anesthesia combined with epidural anesthesia will have an inhibitory effect on the immune function of patients, but will not cause tumor metastasis in patients, and clinical treatment with intravenous anesthesia is more effective.