七氟醚结合顺苯磺阿曲库胺对腹腔镜下肠癌手术中老年患者麻醉效果和免疫功能的影响  

Effect of sevoflurane combined with cisbenzenesulfonate atracurium on anesthesia and immune function in elderly patients undergoing laparoscopic colorectal cancer surgery

作　　者：郑萍 邴淼 汪建胜 ZHENG Ping;BING Miao;WANG Jiansheng(Department of Anesthesiology,Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China)

机构地区：[1]上海市宝山区中西医结合医院麻醉科,上海201900

出　　处：《临床与病理杂志》2021年第7期1622-1628,共7页Journal of Clinical and Pathological Research

摘　　要：目的:探讨七氟醚结合顺苯磺阿曲库胺麻醉对行腹腔镜下肠癌手术的老年患者免疫功能的影响。方法:选取2018年1月至2019年12月上海市宝山区中西医结合医院收治的80例行腹腔镜下肠癌手术的老年患者,根据计算机随机分配原则均分为两组。对照组(n=40)接受丙泊酚联合芬太尼药物麻醉;研究组(n=40)在对照组基础上结合顺苯磺阿曲库胺麻醉。比较两组的手术指标、术后苏醒状况、免疫指标、白介素-6(interleukin 6,IL-6)水平以及不良反应情况。结果:研究组手术指标均明显优于对照组,自主呼吸恢复时间、苏醒时间、拔管时间和定向力恢复时间均短于对照组(P<0.05);术后24 h,研究组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平高于对照组,IL-6水平低于对照组,差异均有统计学意义(P<0.05),且两组患者CD8^(+)、不良反应发生率差异无统计学意义(P>0.05)。结论:在腹腔镜下肠癌手术中对老年患者行七氟醚结合顺苯磺阿曲库胺麻醉能够有效改善患者手术治疗效果,改善患者术后康复情况,降低对患者免疫功能的抑制程度,治疗安全性理想,可在临床广泛应用。Objective:To investigate the effect of sevoflurane combined with cisbenzenesulfonate atracurium on the anesthetic effect and immune function of elderly patients undergoing laparoscopic bowel cancer surgery.Methods:From January 2018 to December 2019,80 elderly patients undergoing laparoscopic bowel cancer surgery at Baoshan Hospital of Integrated Traditional Chinese and Western Medicine were selected.They were divided into two groups according to the principle of random allocation by computer.The control group(n=40)received propofol combined with fentanyl anesthesia,and the study group(n=40)was anesthetized with cisbenzenesulfonate atracurium on the basis of the control group.The surgical indicators,postoperative recovery status,immune indicators,interleukin-6(IL-6)levels and adverse reactions were compared between the two groups.Results:The operation indexes of the study group were significantly better than those of the control group,and the recovery time of spontaneous breathing,recovery time,extubation time and orientation recovery time of the study group were shorter than those of the control group(P<0.05);24 h after operation,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+) of the study group were higher than those of the control group,and the levels of IL-6 were lower than those of the control group,and the differences were statistically significant(P<0.05).CD8^(+) levels and incidence of adverse reactions rate between the two groups were not statistically significant(P>0.05).Conclusion:Sevoflurane combined with cisbenzenesulfonate atracurium for the anesthesia of elderly patients during laparoscopic bowel cancer surgery can effectively improve the surgical treatment effect and postoperative recovery,and reduce the suppression degree of the immune function,The treatment safety is ideal,and it can be widely used in clinical practice.

关 键 词：丙泊酚 七氟醚 顺苯磺阿曲库胺 腹腔镜 肠癌手术 免疫功能 

分 类 号：R614[医药卫生—麻醉学] R735[医药卫生—外科学]