七氟醚对宫颈癌患者围术期炎性应激反应的影响  

The effect of anesthesia with sevoflurane on the perioperative serum cytokines in cervical cancer patients

作　　者：修玉芳[1] 黄东林[1] 邓燕杰[2] 

机构地区：[1]大连市妇产医院麻醉科,辽宁大连116033 [2]大连市妇产医院妇产科,辽宁大连116033

出　　处：《中国微生态学杂志》2012年第11期1022-1023,共2页Chinese Journal of Microecology

摘　　要：目的研究七氟醚麻醉对宫颈癌患者围术期血清相关细胞因子的影响。方法将组织学诊断为宫颈癌的患者90例,按手术时采用的麻醉药物的不同随机分为三组:第Ⅰ组患者为异丙酚组(Ⅰ组,n=30);第Ⅱ组患者为七氟醚组(Ⅱ组,n=30);第Ⅲ组患者为异丙酚+七氟醚组(Ⅲ组,n=30);观察麻醉前30 min,手术开始后1、2 h,手术结束后1、24和48 h六个时点患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)和白细胞介素-10(IL-10)水平的变化。结果三组患者术后血清TNF-α、IL-8和IL-10水平与麻醉前值比较均升高(P<0.01),一般在术后24 h达峰值。比较血清TNF-α、IL-8和IL-10浓度变化,Ⅰ组和Ⅱ组之间差异无统计学意义,Ⅲ组抑制这三种细胞因子释放的能力明显强于Ⅰ组和Ⅱ组(P<0.05)。结论应用七氟醚或异丙酚进行麻醉维持在官颈癌手术中,两者控制炎性应激反应的作用类似;七氟醚联合异丙酚进行麻醉维持可更有效地降低术后炎性应激反应。Objective To study the anesthesia performed with sevoflurane on the perioperative serum cytokines in cervical cancer patients. Methods ASA Ⅰ or Ⅱpatients aged 32 - 54 years weighing 58 - 79 kg were randomly divided into three groups （n = 30 each） ：Propofol group （Group Ⅰ） ; Sevoflurane group （Group Ⅱ） and Sevoflurane ＋ Propofol group （Group Ⅲ）. The levels of serum TNF-α, interleukin-8 and interleukin-10 were observed at six time points： before anesthesia, at 1 and 2 hours after the surgery began, at 1, 24 and 48 hours after the end of surgery. Results The levels of serum TNF-α, IL- 8 and IL-10 increased significantly after the operation, reached at peak values at 24 hours （P 〈 0.05 ） , and then gradually declined but still higher than the baseline values. The serum TNF-α, IL-8 and IL-10 were significantly higher at 1, 24 and 48 hours after the end of surgery in group Ⅰ and Ⅱthan those in group Ⅲ（ P 〈 0.05 ）. Conclusion The anesthesia by sevoflurane inhalation combined with propofol during the surgery of cervical cancer can more efficiently suppress the inflammatory response to surgery by promoting the increase of anti-inflammatory cytokine.

关 键 词：七氟醚 细胞因子 肿瘤坏死因子-Α 白细胞介素-8 白细胞介素-10 

分 类 号：R73[医药卫生—肿瘤]