静吸复合全麻对老年腹腔镜胃癌根治术和开腹胃癌根治术患者免疫功能的影响  

Effect of combined intravenous and inhalation anesthesia on immunologic function in elderly patients underwent radical operation for stomach carcinoma via laparoscope or laparotomy

作　　者：刘燕洁[1] 梁宁[1] 甘丽霞[1] 张学刚[1] 

机构地区：[1]广西壮族自治区人民医院麻醉科,南宁市530021

出　　处：《微创医学》2011年第5期404-406,共3页Journal of Minimally Invasive Medicine

摘　　要：目的探讨静吸复合全麻对老年腹腔镜胃癌根治术和开腹胃癌根治术患者免疫功能的影响。方法将100例老年胃癌根治术患者分为腹腔镜A组和开腹B组各50例,均行静吸复合全麻。记录两组患者年龄、体重、手术时间、失血量,以及麻醉前、术毕及术后72 h采用流式细胞仪检测胃癌患者外周血T淋巴细胞亚群及NK细胞数量。结果术毕各组CD3+、CD4+、CD4+/CD8+均较麻醉前下降(P<0.05),开腹组较腹腔镜组下降明显(P<0.05);术后72 h两组各项指标均恢复至麻醉前水平。结论与开腹手术相比,静吸复合全麻对老年腹腔镜胃癌根治术患者的免疫功能影响小,腹腔镜胃癌根治术老年患者免疫功能术后恢复快。Objective To investigate the effect of combined intravenous and inhalation anesthesia （CIIA） on the immunologic function in elderly patients underwent laparoscope or laparotomy radical operation for stomach carcinoma. Methods 100 elderly patients of stomach carcinoma were divided into laparotomy operation group （ group A） and laparoseope operation group （ group B） with 50 cases in each group ; all the patients were given CIIA. The age,weight, operation time, blood loss were collected, the T lymphocyte subsets and NK ceils of peripheral blood were tested by flow cytometry at the time point of pre-anesthesia, end of operation and 72h post-anesthesia. Results At the end of operation, the number of CD3＋ , CD4 ＋ , CD4 ＋ / CD8＋ were significantly decreased compared to pre-anesthesia （ P 〈 0. 05 ）, and the decrease was more apparent in the lapar0tomy operation group than in the laparoseope group （ P 〈 0.05 ）. The T lymphocyte subsets and NK cells of the two groups recovered to normal levels at 72h post-anesthesia. Conclusion Compared to laparotomy operation, CIIA exerts less influence on the immunologic function of the elderly patients with laparoscope operation. The immunologic function of elderly patients underwent radical operation of stomach carcinoma via laparoscope recovered sooner.

关 键 词：静吸复合全麻 腹腔镜胃癌根治术 免疫功能 开腹胃癌根治术 老年人 

分 类 号：R614.2[医药卫生—麻醉学]