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目的:探讨全麻与全麻复合硬膜外麻醉对直肠癌根治术病人免疫功能的影响。方法:根据麻醉方案将60例行直肠癌根治术的患者分为观察组(全麻复合硬膜外麻醉)30例与对照组(全身麻醉)30例。测定两组患者麻醉前、术后2h、术后24h的血浆皮质醇(Cor)及T淋巴细胞亚群CD8+、CD4+、CD3+水平。结果:相较于对照组,观察组术后2h、术后24h的Cor及CD4+、CD3+水平更为稳定,其中观察组Cor水平显著低于对照组(P<0.05),CD4+、CD3+显著高于对照组(P<0.05)。结论:全麻复合硬膜外麻醉可以有效阻断手术创伤刺激向中枢神经传导,减少应激反应,避免全麻药物对免疫功能的抑制作用,十分适用于行直肠癌根治术的患者。
Objective: To investigate the effects of general anesthesia and general anesthesia combined with epidural anesthesia on immune function in patients undergoing radical resection of rectal cancer. Methods: According to the anesthesia protocol, 60 patients undergoing radical resection of rectal cancer were divided into observation group (general anesthesia combined with epidural anesthesia) 30 cases and control group (general anesthesia) 30 cases. The levels of plasma Cortisol (Cor) and T lymphocyte subsets CD8 +, CD4 + and CD3 + were measured before anesthesia, 2 hours after operation and 24 hours after operation. Results: The levels of Cor and CD4 +, CD3 + in the observation group were more stable at 2h after operation and in the observation group than those in the control group. The Cor level in the observation group was significantly lower than that in the control group (P <0.05), and the levels of CD4 + and CD3 + Control group (P <0.05). Conclusion: Anesthesia combined with epidural anesthesia can effectively block the traumatic stimulation to the central nervous system, reduce the stress response and avoid the inhibitory effect of general anesthetics on immune function. It is very suitable for patients undergoing radical resection of rectal cancer.