利多卡因对宫颈癌根治患者血浆和腹腔引流液炎性因子的影响  

The Effects of Lidocaine Infusion on Inflammatory Factors in Plasma and Peritoneal Fluid in Patients Undergoing Radical Hysterectomy

作　　者：刘婷婷 张素玲[2] 靳茜茜[2] 温菲[2] 类维富[2] 王焕亮 

机构地区：[1]山东大学附属济南市中心医院麻醉科,山东济南250012 [2]山东大学齐鲁医院麻醉科 [3]山东大学深圳研究院

出　　处：《潍坊医学院学报》2017年第5期324-326,356,共4页Acta Academiae Medicinae Weifang

基　　金：深圳市科技计划项目(课题编号:JCYJ20150402105524051);山东省自然科学基金(课题编号:2015ZRE27075)

摘　　要：目的观察围术期静脉输注利多卡因对宫颈癌根治术患者血浆和腹腔引流液炎性因子表达的影响,探讨利多卡因的抗炎机制。方法选择全麻下行宫颈癌根治患者30例,随机分为对照组(C组)和利多卡因组(L组),各15例。L组诱导前15min静脉推注利多卡因1.5mg/kg,随后持续泵入利多卡因1.5mg/(kg·h)至患者离室,C组给予等容量生理盐水。ELISA检测血浆和腹腔引流液各时点白介素-6(IL-6),高迁移率族蛋白B1(HMGB1)水平。结果术后3h,6h L组体温低于C组,术后6h,L组心率亦低于C组(P<0.05)。术后24h,L组血浆白细胞计数低于C组(P<0.05)。术后24h,L组HMGB1血浆和腹腔引流液浓度均低于C组(P<0.05)。与术前比较,术后3h,6h,12h,C组、L组血浆IL-6浓度均升高。术后3h,6h,L组血浆和腹腔引流液IL-6浓度低于C组(P<0.05)。术后12h,L组腹腔引流液中IL-6浓度亦低于C组。结论围术期静脉输注利多卡因可减轻宫颈癌根治术患者术后炎症反应,抑制炎性因子表达。因此,利多卡因在宫颈癌根治术患者围术期应用有一定临床价值。Objective To observe the effect of perioperative infusion of lidocaine on the expression of inflammatory factors in plasma and peritoneal drainage fluid of patients undergoing radical hysterectomy and to explore the anti-inflammatory mechanism of lidocaine.Methods Thirty cervical cancer patients who scheduled for radical hysterectomy under geneal anesthesia were randomly divided into two groups： the lidocaine group（ L group） and the control group（ C group）,each with a total of 15 cases. 1. 5 mg/kg（ 5 ~ 10 min） lidocaine were given in L group 15 min before induction of anesthesia followed by 1. 5 mg/（ kg·h） until patients left the operation room. The same volume of saline was given in C group. The levels of IL-6 and HMGB1 in plasma and peritoneal drainage fluid were detect with enzyme-linked immunosorbent assay（ ELISA） at different time points after the surgery. Results The temperature at 3 h,6 h after surgery in lidocaine group was lower than that in control group,the heart rate at 6 h after surgery was lower than control group（ P 〈0. 05）. Compared with control group,the counts of WBC in lidocaine group decreased at the 24 h after the surgery（ P 〈0. 05）. Levels of HMGB1 in the plasma and peritoneal drainage fluid was lower in lidocaine group compared to control group 24 h after surgery（ P 〈0. 05）. The plasma concentration of IL-6 incrased at 3 h,6 h,12 h after the surgery in two groups compared with before surgery. Compared with control group the concentration of IL-6 in lidocaine group at 3 h,6 h after surgery in both plasma and peritoneal fluid were lower（ P 〈0. 05）. 12 h after surgery,the levers of peritoneal fluid IL-6 in lidocaine group was lower than control group. Conclusions Perioperative intravenous infusion of lidocaine can reduce postoperative inflammatory response and inhibit the expression of inflammatory cytokines in patients undergoing radical resection of cervical cancer. Therefore,the application of lidocaine in patients with cervical cancer during t

关 键 词：宫颈癌根治术 利多卡因 IL-6 HMGB1 

分 类 号：R364.5[医药卫生—病理学]