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目的探讨硬膜外麻醉联合全麻对非小细胞肺癌患者的疗效以及围术期免疫功能的影响。方法选择行手术治疗的非小细胞肺癌患者60例,随机分为两组,每组30例,A组患者术中接受硬膜外麻醉联合全身麻醉,B组患者术中接受静脉全麻。比较两组患者的手术以及术后情况,分别评价两组患者术后VAS评分并进行分析,分别检测并分析两组患者围术期免疫功能的变化。结果 A组患者手术时间、术后苏醒时间、术后拔管时间以及恢复自主呼吸时间较B组显著缩短(P<0.05)。术后3 h及6 h A组患者的VAS评分显著低于B组患者(P<0.05);术毕以及术后A组患者的CD4+以及CD4+/CD8+明显比B组高(P<0.05);且手术结束后,A组患者血清中白介素-6(IL-6)以及肿瘤坏死因子-ɑ(TNF-ɑ)水平明显较B组低(P<0.05)。结论硬膜外麻醉联合全麻用于非小细胞肺癌手术可显著改善患者的手术以及术后情况,利于患者术后免疫功能的恢复,缓解患者术后疼痛,值得临床推广应用。
Objective To investigate the effects of epidural anesthesia combined with general anesthesia on non-small cell lung cancer patients and perioperative immune function. Methods Sixty patients with non-small cell lung cancer who underwent surgical treatment were randomly divided into two groups (n = 30 in each group). Patients in group A received epidural anesthesia combined with general anesthesia during operation and group B received general anesthesia during operation. The postoperative VAS scores of two groups were compared and analyzed. The changes of perioperative immune function of the two groups were detected and analyzed. Results The operation time, postoperative recovery time, extubation time and spontaneous respiration time in group A were significantly shorter than those in group B (P <0.05). The VAS scores of patients in group A at 3 h and 6 h after operation were significantly lower than those in group B (P <0.05). CD4 + and CD4 + / CD8 + of patients in group A at the end of operation and after operation were significantly higher than those in group B (P <0.05). After operation, the levels of serum interleukin-6 (IL-6) and tumor necrosis factor-ɑ (TNF-ɑ) in group A were significantly lower than those in group B (P <0.05). Conclusion Epidural anesthesia combined with general anesthesia for non-small cell lung cancer surgery can significantly improve the patient’s surgery and postoperative conditions, which is conducive to the recovery of postoperative immune function and relieve postoperative pain in patients, which is worthy of clinical application.