丙泊酚和七氟醚对子宫颈癌患者行腹腔镜根治性子宫切除术围术期免疫功能的影响  

Effects of propofol and sevoflurane on the immune functions of cervical cancer patients after laparoscopic radical hysterectomy

作　　者：刘松涛[1,2] 周海[2] 周美艳[2] 曹君利 

机构地区：[1]徐州医科大学研究生学院,江苏徐州221004 [2]徐州市中心医院麻醉科,江苏徐州221009 [3]徐州医科大学麻醉学院,江苏徐州221002

出　　处：《徐州医学院学报》2017年第1期5-9,共5页Acta Academiae Medicinae Xuzhou

摘　　要：目的比较丙泊酚和七氟醚对腹腔镜下行子宫颈癌根治性子宫切除术患者围术期免疫功能的影响。方法择期在全麻下行腹腔镜根治性子宫切除术的子宫颈癌患者60例，随机分为丙泊酚静脉复合麻醉组（P组）和七氟醚吸入复合麻醉组（S组）。P组采用丙泊酚诱导和维持，S组采用七氟醚诱导和维持。在诱导前30min（T0）、术毕即刻（T1）、术后24h（T2）、48h（T3）以及72h（T4）5个时间点采用EDTA抗凝管收集2ml外周血样本。使用流式细胞技术分析CD3^＋、CD4^＋、CD8^＋、B细胞、自然杀伤（natural killer，NK）细胞的计数以及CD4^＋／CD8^＋比值。结果与T0时间点相比，除CD8^＋计数外，2组患者所有免疫指标均显著降低（P〈0．05或P〈0．01）；与P组相比，S组患者术后CD3^＋、CD4^＋、NK细胞计数及CI）4^＋／CD8^＋比值均显著降低（P〈0．05或P〈0．01）。结论腹腔镜下行根治性子宫切除术的子宫颈癌患者围术期淋巴细胞减少，丙泊酚保护外周血淋巴细胞的作用优于七氟醚。Objective To compare the effects of propofol and sevoflrane on the immune functions of cervical cancer patients after laparoscopic radical hysterectomy. Methods A total of 60 cervical cancer patients who were scheduled for laparoscopic radical hysterectomy under general anesthesia were randomly divided into two groups： a propofol intravenous anesthesia group （ Group P） and a sevoflurane inhalation anesthesia group （ Group S）. Groups P and S used propofol and sevoflurane for anesthesia induction and maintenance, respectively. Blood samples were collected 30 min before induction （T0 ） , at the end of operation （T1 ） , and 24 h （T2 ） , 48 h （T3 ） and 72 h （T4 ） after operation. Then, the number of CD3 ＋ , CI）4^＋ , CD8^＋ and natural killer （NK） cells and CD4^＋/CD8^＋ ratio were analyzed by flow eytometry. Results After surgery, all immunological indicators except the number of CD8^＋ cells were significantly decreased in both groups compared with those at TO （P 〈 0.05 or P 〈 0.01 ）. Compared with Group P, Group S showed remarkable decreases in the number of CD3^＋, CD4^＋ and NK cells and CD4^＋/CD8^＋ ratio （P〈0.05 orP〈0.01）. Conclusions Cervical cancer patients show a reduced number of lymphocytes after laparoscopic radical hysterectomy. Propofol can produce the protective effects on the peripheral lymphocytes, which was superior to that of sevoflurane.

关 键 词：丙泊酚 七氟醚 免疫 子宫颈癌 腹腔镜根治性子宫切除术 

分 类 号：R614.2[医药卫生—麻醉学]