不同麻醉方法对胃癌患者IL-1、IL-6、TNF-α水平的影响  

Effects of Different Anesthesia Methods on IL-1,IL-6 and TNF-alpha in Patients with Gastric Cancer

作　　者：康红灿[1] 郭正轩[1] 刘晶涛[1] KANG Hongcan;GUO Zhengxuan;LIU Jingtao(Anyang Hospital,Anyang,455000)

机构地区：[1]河南省安阳地区医院,455000

出　　处：《实用癌症杂志》2019年第5期718-720,共3页The Practical Journal of Cancer

基　　金：河南卫生厅科技基金项目(编号:2014027636)

摘　　要：目的分析不同麻醉方法对胃癌患者IL-1、IL-6、TNF-α的影响。方法选择45例胃癌患者,将患者随机分为三组,分别为全凭静脉麻醉、静吸复合麻醉及硬膜外复合全麻组。在麻醉之前、切皮之前、切皮之后2 h及术后定期检测外周血清中的IL-1、IL-6、TNF-α水平。结果与麻醉前相比,麻醉后的三组IL-1、IL-6、TNF-α并没有明显的改变。切皮2 h、术后1天和3天静吸复合麻醉及全凭静脉麻醉组IL-1水平具有一定的提高(P <0. 05);术后1天,硬膜外复合全麻组患者的IL-1水平提高(P <0. 05)。全凭静脉麻醉、静吸复合全麻组的IL-6水平在切皮后2 h及术后1天与麻醉前对比具有明显的提高(P <0. 05);硬膜外复合全麻组在切皮后2 h、术后1天具有明显的提高(P <0. 05)。三组比较,静吸复合全麻组、全凭静脉麻醉在手术2 h、术后一天IL-1水平比硬膜外复合全麻组要高,三组的IL-6、TNF-α并没有差异。结论硬膜外复合全麻能够有效降低围手术期的应激反应和麻醉药物对于IL-1、IL-6、TNF-α的影响,对肿瘤患者免疫功能的恢复具有重要的作用,值得临床推广使用。Objective To analyze the effects of different anesthesia methods on IL-1,IL-6 and TNF-alpha in patients with gastric cancer. Methods 45 patients with gastric cancer were randomly divided into three groups: total intravenous anesthesia,Intravenous Inhalation Combined Anesthesia and epidural combined general anesthesia. The levels of IL-1,IL-6 and TNF-alpha in peripheral serum were measured regularly before anesthesia,before skin incision,2 hours after skin incision and after operation. Results Compared with before anesthesia,there were no significant changes in IL-1,IL-6 and TNF-alpha in the three groups after anesthesia. The levels of IL-1 in skin incision 2 hours,intravenous anesthesia 1 day and 3 days after operation and total intravenous anesthesia increased to a certain extent( P < 0. 05);the levels of IL-1 in epidural anesthesia group increased 1 day after operation( P < 0. 05). IL-6 in the group of total intravenous anesthesia and Intravenous Inhalation Combined with general anesthesia was significantly increased 2 hours after skin incision and 1 day after operation compared with that before anesthesia( P < 0. 05),while that in the group of epidural tissue was significantly increased 2 hours after skin incision and 1 day after operation( P < 0. 05). Compared with the epidural anesthesia group,the intravenous anesthesia group,the intravenous anesthesia group and the intravenous anesthesia group had higher IL-1 level than the epidural anesthesia group. There was no difference in IL-6 and TNF-alpha among the three groups. Conclusion Epidural anesthesia combined with general anesthesia can effectively reduce the perioperative stress response and the influence of anesthetics on IL-1,IL-6 and TNF-alpha. It plays an important role in the recovery of immune function of cancer patients and is worthy of clinical application.

关 键 词：全凭静脉麻醉 胃癌 静吸复合麻醉 

分 类 号：R735.2[医药卫生—肿瘤]