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目的探讨单纯全身麻醉和硬膜外复合静脉全身麻醉在腹腔镜结肠癌根治术中的应用效果。方法 80例腹腔镜结肠癌根治术患者,随机分为对照组和观察组,各40例。对照组使用单纯全身麻醉方法,观察组应用硬膜外复合静脉全身麻醉方法。比较两组患者麻醉诱导30 min(T1)、切皮后2 h(T2)、完成后1 d(T3)CD3+、CD4+/CD8+水平、自然杀伤细胞(NK)活性数百分比以及白细胞介素-6水平。结果 T1时,两组患者CD3+、CD4+/CD8+水平均明显高于T2、T3时,异具有统计学意义(P<0.05)。T2、T3时,对照组CD3+、CD4+/CD8+水平均低于观察组,差异具有统计学意义(P<0.05)。T1~T3时,两组NK活性数百分比比较差异无统计学意义(P>0.05)。T1时,两组患者白细胞介素-6水平均明显低于T2、T3时,差异具有统计学意义(P<0.05)。T2、T3时,对照组白细胞介素-6水平分别为(98.27±10.52)、(89.72±12.85)pg/ml,均高于观察组的(92.39±9.15)、(81.46±12.62),差异具有统计学意义(P<0.05)。结论腹腔镜结肠癌手术患者应用硬膜外复合静脉全身麻醉方法,对机体免疫抑制性弱,且对白细胞介素-6的影响较小,可在基层医院中广泛应用。
Objective To investigate the effect of simple general anesthesia and epidural combined intravenous general anesthesia in laparoscopic radical mastectomy. Methods Eighty patients undergoing laparoscopic radical resection of colon cancer were randomly divided into control group and observation group, 40 cases in each. The control group using simple general anesthesia, observation group application of epidural composite intravenous general anesthesia. The percentages of CD3 +, CD4 + / CD8 +, natural killer (NK) activity and the percentage of interleukin-6 in the two groups after anesthesia induction for 30 min (T1), 2 h post- Level. Results At T1, the levels of CD3 + and CD4 + / CD8 + in both groups were significantly higher than those in T2 and T3 (P <0.05). The levels of CD3 + and CD4 + / CD8 + in the control group were lower than those in the observation group at T2 and T3, the difference was statistically significant (P <0.05). At T1 ~ T3, there was no significant difference in the percentage of NK activity between the two groups (P> 0.05). At T1, the levels of interleukin-6 in both groups were significantly lower than those in T2 and T3 (P <0.05). The levels of interleukin-6 in the control group were (98.27 ± 10.52) and (89.72 ± 12.85) pg / ml at T2 and T3 respectively, which were higher than those in the observation group (92.39 ± 9.15 and 81.46 ± 12.62) Statistical significance (P <0.05). Conclusion The application of epidural combined intravenous anesthesia in patients undergoing laparoscopic colon cancer surgery has weak immunosuppressive effect on the body and has little effect on interleukin-6. It can be widely used in primary hospitals.