硬膜外阻滞复合全麻对胃癌手术患者血浆IL-2、IL-4浓度的影响  

Effect of epidural block combined with general anesthesia on serum IL-2, IL-4 levels in patients with gastric cancer after operation

作　　者：黄剑波[1] 黄强[1] 涂素兰[1] 

机构地区：[1]江门市第二人民医院麻醉科,广东江门529030

出　　处：《海南医学》2013年第18期2678-2680,共3页Hainan Medical Journal

摘　　要：目的观察硬膜外阻滞复合全麻对胃癌手术患者血浆IL-2、IL-4浓度的影响。方法选取我院2009年5月至2011年12月收治的ASAⅠ～Ⅱ级需行胃癌根治术患者90例，随机分为A、B、C三组，每组均为30例。A组患者采用硬膜外阻滞麻醉，B组患者采用静吸复合全麻，A、B两组均为对照组；C组患者采取硬膜外阻滞复合全麻，即为观察组。观察并比较三组患者麻醉后体内IL-2、IL-4、NO含量。结果三组患者在麻醉后切皮前体内IL-2、IL-4、NO含量无明显变化，A、B两组患者手术后2h、1d、3dIL-2、IL-4含量明显降低，而C组患者IL-2、IL-4含量只在术后1d降低，且降低的幅度小于A、B两组患者。切皮后2h、1d、3d，C组患者较A、B组患者NO含量明显增高，差异均具有统计学意义（P〈0．05）。结论硬膜外阻滞复合全麻的患者相比于硬膜外阻滞麻醉以及复合全麻，对体内IL-2、IL-4的抑制作用弱，且能增加体内NO的含量，减少人体的应激反应，有利于手术的顺利进行，值得临床推广。Objective To observe the effect of epidural block combined with general anesthesia on serum IL-2, IL-4 levels in patients with gastric cancer after operation. Methods Ninety ASA Ⅰ-Ⅱ grade patients sehed- uled for radical gastrectomy admitted to our hospital from May 2009 to December 2011 were randomly divided into three groups： group A, group B, group C, with 30 cases in each group. Patients in group A were treated by epidural an- esthesia inhalation anesthesia, patients in group B general anesthesia, and those in group C were treated by epidural block combined with general anesthesia. The levels of IL-2, IL-4, NO were observed and compared between the three groups. Results The three groups showed no significant change in the levels of IL-2, IL-4 before anesthesia. The levels of IL-2, IL-4 in group A, group B were significantly decreased 2 h, 1 day, 3 days after surgery, and those in group C patients were significantly decreased only in the first day after surgery, with smaller decrease than that of group A and group B. The NO contents 2 h, 1 day, 3 days after surgery were significantly increased in group C than group A, group B, with statistically significant difference （P〈0.05）. Conclusion Epidural block combined with gen- eral anesthesia, compared with epidural anesthesia or general anesthesia, exerts weaker inhibitory effect on IL-2, IL-4, increases the content of NO in the body, and reduces the stress response, which is conducive to the smooth prog- ress of the surgery and worthy of promotion.

关 键 词：硬膜外阻滞复合全麻 胃癌手术 IL-2 IL-4 NO含量 

分 类 号：R735.2[医药卫生—肿瘤]