七氟烷和丙泊酚全麻复合硬膜外阻滞麻醉对宫颈癌患者术后苏醒、免疫水平的影响  

Effect of Combined Epidural-general Anesthesia Using Sevoflurane and Propofol on the Recovery and Immune Level of Patients Undergoing Cervical Cancer Surgery

作　　者：王贵罗[1] 樊顺克[1] WANG Guiluo;FAN Shunke(Nanyang Second People's Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市第二人民医院,473000

出　　处：《实用癌症杂志》2021年第11期1821-1824,共4页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191430)。

摘　　要：目的研究七氟烷和丙泊酚全麻复合硬膜外阻滞麻醉对宫颈癌患者术后苏醒、免疫水平的影响。方法选取76例宫颈癌患者作为研究对象,患者均接受腹腔镜手术,并根据麻醉方式分为对照组(n=38)和观察组(n=38)。对照组采用七氟烷和丙泊酚全麻,观察组在对照组的基础上采用硬膜外阻滞麻醉。对比2组患者术后苏醒情况(自主呼吸恢复时间、清醒时间、胃肠恢复时间);对比2组患者麻醉前和术后12 h、24 h免疫水平变化;对比2组患者麻醉质量和术后麻醉副反应发生率。结果相比于对照组,观察组自主呼吸恢复时间、清醒时间和胃肠恢复时间更短(P<0.05)。术后12 h,2组患者CD3+、CD4+/CD8+水平均较麻醉前降低,但相比于实验组,对照组下降更多;术后24 h,2组患者CD3+、CD4+/CD8+水平均较术后12 h升高,且相比于对照组,观察组上升更显著(P<0.05)。相比于对照组麻醉优良率73.68%(28/38),观察组的94.73%(36/38)更高(P<0.05)。对照组麻醉副反应发生率为7.89%(3/38),观察组为5.26%(2/38),相比差异不具有统计学意义(P>0.05)。结论七氟烷和丙泊酚全麻复合硬膜外阻滞麻醉对宫颈癌患者的麻醉质量较高,能够有效缩短患者的术后苏醒时间,对患者免疫水平的影响较小,并且不会增加麻醉副反应。Objective To study the effect of combined epidural-general anesthesia using sevoflurane and propofol on the recovery and immune level of patients undergoing cervical cancer surgery.Methods 76 patients with cervical cancer underwent laparoscopic surgery were selected,and divided into 2 groups according to different anesthesia methods,each with 38 cases.The control group received sevoflurane and propofol during general anesthesia,while the observation group received combined epidural-general anesthesia using sevoflurane and propofol.Then various indexes were compared between the 2 groups,including anesthesia recovery status(recovery time of spontaneous breathing,wake-up time and gastrointestinal recovery time),immune level at baseline,and 12 h and 24 h after operation,as well as the anesthetic quality and the incidence rate of postoperative anesthetic side effects.Results The recovery time of spontaneous breathing,wake-up time and gastrointestinal recovery time were significantly shorter in the observation group than the control group(P<0.05).At postoperative 12 h,a decrease was observed in CD3+and CD4+/CD8+levels of all patients,and the decrease was more obvious in control group than in the observation group;At postoperative 24 h,CD3+and CD4+/CD8+levels were gradually increased in the 2 groups compared with the levels at postoperative 12 h,and the increase was more significant in the observation group than the control group(P<0.05).The excellent anesthesia effect rate was 73.68%(28/38)in the control group,which was significantly lower than 94.73%(36/38)in the observation group(P<0.05).The incidence rate of postoperative anesthetic side effects was 7.89%(3/38)in the control group and 5.26%(2/38)in the observation group,with no statistical differences(P>0.05).Conclusion Application of sevoflurane and propofol in combined epidural-general anesthesia during cervical cancer surgery achieves excellent anesthesia effect,which can effectively shorten the postoperative anesthesia recovery time without influencing immune le

关 键 词：七氟烷 丙泊酚 硬膜外阻滞麻醉 宫颈癌 术后苏醒 免疫水平 

分 类 号：R737.33[医药卫生—肿瘤]