全凭静脉麻醉复合七氟烷对肝癌切除术患者血清MBP、Aβ1-40水平的影响  

Effect of Total Intravenous Anesthesia Combined with Sevoflurane on Serum MBP and Aβ1-40 levels in Patients Undergoing Hepatectomy

作　　者：李波 LI Bo(Dezhou United Hospital,Shandong Province,Dezhou 253000,China)

机构地区：[1]山东省德州联合医院,山东德州253000

出　　处：《中国医学创新》2022年第23期51-55,共5页Medical Innovation of China

摘　　要：目的:分析全凭静脉麻醉复合七氟烷对肝癌切除术患者血清髓鞘碱性蛋白(MBP)、β淀粉样蛋白1-40(Aβ1-40)水平的影响。方法:选择2020年6月-2021年6月德州联合医院收治的行肝癌切除术患者80例为研究对象,随机将其分为对常规麻醉组和联合七氟烷组,各40例。常规麻醉组采用阿托品联合苯巴比妥钠麻醉,联合七氟烷组采用全凭静脉麻醉复合七氟烷麻醉。分析两组手术情况、炎症因子、免疫因子以及认知相关因子的水平变化。结果:两组手术时间、术中出血量、住院时间、肛门排气时间相比,差异均无统计学意义(P>0.05)。术后即刻及术后3 d,两组的白介素-2(IL-2)水平较术前均下降,肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)水平较术前均上升,且联合七氟烷组的IL-2均高于常规麻醉组,TNF-α、IL-10水平均低于常规麻醉组,差异均有统计学意义(P<0.05)。术后即刻及术后3 d,两组的CD3^(+)、CD4^(+)/CD8^(+)较术前均下降,自然杀伤细胞(NK)较术前均上升,且联合七氟烷组的CD3^(+)、CD4^(+)/CD8^(+)均高于对照组,NK均低于常规麻醉组,差异均有统计学意义(P<0.05)。术后即刻及术后3 d,两组的同型半胱氨酸(Hcy)、MBP、Aβ1-40较术前水平均下降,且联合七氟烷组的Hcy、MBP、Aβ1-40水平均低于常规麻醉组,差异均有统计学意义(P<0.05)。结论:在肝癌切除术中应用全凭静脉麻醉复合七氟烷对患者免疫功能及认知情况影响较小,可减轻机体应激反应及炎症反应,效果优异。Objective:To analyze the effects of total intravenous anesthesia combined with Sevoflurane on serum myelin basic protein(MBP)andβamyloid 1-40(Aβ1-40)levels in patients undergoing hepatectomy for hepatocellular carcinoma.Method:A total of 80 patients undergoing hepatectomy for hepatocellular carcinoma admitted to Dezhou United Hospital from June 2020 to June 2021 were selected for the study,they were randomly divided into conventional anesthesia group and combined sevoflurane group,40 cases in each group.The conventional anaesthesia group was anaesthetized with Atropine combined with Sodium Phenobarbital,the combined Sevoflurane group was anaesthetized with total intravenous anaesthesia combined with Sevoflurane.The changes in surgical conditions,levels of inflammatory factors,immune factors,and cognitive-related factors in the two groups were analyzed.Result:There were no statistical differences in the operative time,intraoperative bleeding,hospital stay,and anal venting time between the two groups compared with each other(P>0.05).Immediately and 3 d after operation,the levels of interleukin-2(IL-2)in the two groups were decreased,the levels of tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)were increased,and the levels of IL-2 in the combined Sevoflurane group were higher than those in the conventional anesthesia group,and the levels of TNF-αand IL-10 were lower than those in the conventional anesthesia group,the differences were statistically significant(P<0.05).Immediately after operation and 3 d after operation,CD3^(+)and CD4^(+)/CD8^(+)in the two groups were decreased compared with those before operation,and natural killer cells(NK)were increased compared with those before operation,the CD3^(+)and CD4^(+)/CD8^(+)in the combined Sevoflurane group were higher than those in the control group,and NK was lower than that in the conventional anesthesia group,the differences were statistically significant(P<0.05).Immediately and 3 d after operation,homocysteine(Hcy),MBP and Aβ1-40 in the two groups wer

关 键 词：七氟烷 肝癌切除术 全凭静脉麻醉 免疫因子 认知相关因子 

分 类 号：R614[医药卫生—麻醉学] R735.7[医药卫生—外科学]