全身麻醉与硬膜外麻醉深麻醉与浅麻醉对宫颈癌患者的麻醉效果比较  

Comparison of anesthetic effects of general anesthesia and epidural anesthesia,deep anesthesia and shallow anesthesia for cervical cancer patients

作　　者：姬世兴 张雪峰 白洁[2] Ji Shixing;Zhang Xue feng;Bai Jie(Anesthesiology Department,Fugu County Hospital of Traditional Chinese Medical Hospital,Shaanxi 719499,China)

机构地区：[1]陕西省府谷县中医医院麻醉科,719499 [2]西安交通大学第二附属医院麻醉科

出　　处：《山西医药杂志》2018年第15期1750-1752,共3页Shanxi Medical Journal

基　　金：陕西省卫生厅科研基金(08E10 2008)

摘　　要：目的比较全身麻醉与硬膜外麻醉、深麻醉与浅麻醉对宫颈癌患者的麻醉效果。方法选取2015年1月至2017年12月在我院进行手术治疗的宫颈癌患者198例,随机分为对照组和观察组各99例。对照组采用全身麻醉,观察组采用硬膜外麻醉。比较2组术中出血量、手术时间及不同麻醉深度、不同时间的T细胞亚群。结果2组的术中出血量以及手术时间相比差异均无统计学意义(P>0.05);与同组麻醉前5min(T_0)相比,2组患者麻醉后2h(T_1)和术后第1天(T_2)时间点的T细胞亚群水平均明显降低(P<0.05);术后第3天(T_3)时出现恢复,但仍明显低于T_0(P<0.05);术后第5天(T_4)观察组的T细胞亚群水平恢复到麻醉前,对照组的T细胞亚群水平仍低于麻醉前(P<0.05);术后第7天(T_5)对照组的各免疫指标均恢复。2组深麻醉宫颈癌患者手术后的CD4^+、CD3^+、CD8^+以及CD4^+/CD8^+均明显高于浅麻醉患者(P<0.05),且浅麻醉患者的T细胞亚群水平在T_5恢复至麻醉前,深麻醉患者在T_4恢复至麻醉前。结论宫颈癌患者采取硬膜外麻醉对围术期免疫功能的影响小于全身麻醉,且深麻醉对患者免疫功能的影响小于浅麻醉。Objective To explore the anesthetic effects of general anesthesia and epidural anesthesia,deep anesthesia and shallow anesthesia for cervical cancer patients.Methods A total of 198cases of patients with cervical cancer who were treated in our hospital from January 2015to December 2017were enrolled and divided into control group and observation group randomly,99cases in each group.The control group received general anesthesia,while the observation group received epidural anesthesia.The intraoperative blood loss,operative time,the level of T lymphocyte subsets in different time in two groups was compared.Results There was no significant difference in bleeding volume and operative time between the two groups（P〈0.05）.Compared with T0,the level of T lymphocyte subsets at the time point of T1and T2in the two groups decreased significantly（P〈0.05）,while T3appeared to be recovered,but it was still lower than T0（P〈0.05）.The level of T lymphocyte subsets in the T4observation group was restored before anesthesia,and the level of T lymphocyte subsets in the control group was still lower than that before anesthesia（P〈0.05）,and all the immune indexes in the T5control group recovered.The T lymphocyte subsets of patients with deep anesthesia were significantly higher than those in the shallow anesthesia（P〈0.05）,and the level of T lymphocyte subsets in the shallow anesthetized patients was restored to that before the anesthesia in 75,and the patients in the deep anesthesia recovered to that before the anesthesia in T4.Conclusion The effect of epidural anesthesia on perioperative immune function of cervical cancer patients is less than that of general anesthesia,and the effect of deep anesthesia on patients＇immune function is less than that of shallow anesthesia.

关 键 词：麻醉 全身 麻醉 硬膜外 宫颈肿瘤 深麻醉 浅麻醉 

分 类 号：R614[医药卫生—麻醉学] R737.33[医药卫生—外科学]