CAJ | 학술논문

目的比较全身麻醉与全身麻醉复合硬膜外腔阻滞麻醉对胃癌手术患者血清T淋巴细胞亚群及白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平的影响.方法选择60例胃癌手术患者,按数字表法随机分为I组和Ⅱ组各30例,I组采用全身麻醉方法,Ⅱ组采用全身麻醉复合硬膜外腔阻滞麻醉方法,分别于麻醉前、麻醉后2 h、术后1 d和术后6 d检测两组血清CD3+、CD4+、CD4+/CD8+及IL-6、IL-10、TNF-α的水平,并进行比较.结果两组麻醉后2 h、术后1 d血清CD3+、CD4+、CD4+/CD8+水平均较麻醉前明显下降(均P＜0.05),且I组下降水平大于Ⅱ组(P＜0.05);两组麻醉后2h血清IL-6水平均明显升高(均P＜0.05),两组IL-10、TNF-α水平无明显变化(均P＞0.05).术后6 d两组各项观察指标均恢复至术前水平.结论全身麻醉复合硬膜外腔阻滞麻醉对胃癌手术患者术后免疫功能有一过性抑制作用,且抑制程度轻于全麻身麻醉方法,而对患者的炎性反应影响较小.
목적 비교전신마취여전신마취복합경막외강조체마취대위암수술환자혈청T림파세포아군급백세포개소-6(IL-6)、백세포개소-10(IL-10)、종류배사인자-α(TNF-α)수평적영향.방법 선택60례위암수술환자,안수자표법수궤분위I조화Ⅱ조각30례,I조채용전신마취방법,Ⅱ조채용전신마취복합경막외강조체마취방법,분별우마취전、마취후2 h、술후1 d화술후6 d검측량조혈청CD3+、CD4+、CD4+/CD8+급IL-6、IL-10、TNF-α적수평,병진행비교.결과 량조마취후2 h、술후1 d혈청CD3+、CD4+、CD4+/CD8+수평균교마취전명현하강(균P＜0.05),차I조하강수평대우Ⅱ조(P＜0.05);량조마취후2h혈청IL-6수평균명현승고(균P＜0.05),량조IL-10、TNF-α수평무명현변화(균P＞0.05).술후6 d량조각항관찰지표균회복지술전수평.결론 전신마취복합경막외강조체마취대위암수술환자술후면역공능유일과성억제작용,차억제정도경우전마신마취방법,이대환자적염성반응영향교소.
Objective To study the effects of different anesthesia methods on postoperative changes in T-lymphocyte subsets and IL-6、IL-10、TNF-α in the patients undergoing operation of stomach carcinoma.Methods 60 patients with stomach carcinoma were randomly divided into group I(general anaesthesia)and Ⅱ(general combined epidural anesthesia).The level of T-lymphocyte subsets and IL-6、IL-10、TNF-αt were respectively detected and compared before anesthesia,2 h after anesthesia,ld and 6 d after operation.Results CD3+ 、CD4+ 、CD4+/CD3+ decreased,but IL-6 increased at the end of 2 h after anesthesia,l d after operation compared with those before anesthesia(all P＜0.05).While IL-10、TNF-α had no statistical significance(all P＞0.05).At 6 d after operation,the values recovered to the level before anesthesia in two groups.Conclusion The immune function in patients with gastric cancer decreaseed after anesthesia,it was more serious in geteral anaesthesia than that of general combined epidural anesthesia.But anesthesia had little influence on inflammatory response.