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为探讨手术及麻醉对消化道肿瘤病人围手术期血清细胞因子的影响,将60例患者随机分成两组,分别选择吸入全麻和静吸复合全麻两种麻醉方式。采用ELISA法对患者术前、术毕4h内和术后1周血清TNF-α、ΙL-6的水平进行检测。结果:患者TNF-α水平术前低于正常(P<0.01),术毕术后升高,术后1周仍低于正常(P<0.01);IL-6水平术前高于正常(P<0.01),术毕明显高于术前(P<0.01),术后1周降至正常;术毕时,IL-6水平在两种不同麻醉组有显著差异(P<0.05);术后1周TNF-α与IL-6呈正相关(P<0.05)。提示检测手术前后细胞因子水平变化可作为肿瘤病人细胞免疫功能监测和衡量应激反应的指标。阿片类麻醉药能抑制应激反应引起的细胞因子释放
To investigate the effect of surgery and anesthesia on perioperative serum cytokines in patients with digestive tract cancer, 60 patients were randomly divided into two groups, inhalation of general anesthesia and inhalation combined with general anesthesia two kinds of anesthesia. The levels of serum TNF-α and ΙL-6 were measured by ELISA before, 4 and after surgery. Results: The level of TNF-α was lower than normal before operation (P<0.01), increased after operation, and remained below normal after 1 week (P<0.01); In normal (P<0.01), the operation was significantly higher than before operation (P<0.01), and it decreased to normal one week after operation. When the operation was completed, IL-6 levels were significantly different in the two different anesthesia groups. (P<0.05); TNF-α was positively correlated with IL-6 at 1 week postoperatively (P<0.05). It is suggested that the detection of changes in cytokine levels before and after surgery can serve as an indicator for the monitoring of cellular immune function and measurement of stress responses in cancer patients. Opioid anesthetics suppress the release of cytokines caused by stress