全麻联合硬膜外麻醉对胃癌根治术患者炎症、应激反应的影响  

Effect of general anesthesia combined with epidural anesthesia on inflammation and stress response in patients undergoing radical gastrectomy

作　　者：文静 胡德俊[1] 王雪涵 WEN Jing;HU Dejun;WANG Xuehan(Department of Anesthesiology,the First People's Hospital of Jintang County,Chengdu,China,610400)

机构地区：[1]金堂县第一人民医院麻醉科,四川成都610400

出　　处：《分子诊断与治疗杂志》2024年第5期791-795,共5页Journal of Molecular Diagnostics and Therapy

基　　金：四川省科技厅项目(2022NSFSC0570)。

摘　　要：目的分析全麻联合硬膜外麻醉对胃癌根治术患者炎症、应激反应的影响。方法选取2020年7月至2023年5月金堂县第一人民医院收治的胃癌根治术患者108例,根据麻醉方式分为对照组53例(全麻)、观察组(全麻联合硬膜外麻醉)55例。比较两组麻醉相关指标、疼痛情况、生命体征变化、炎症、应激反应及不良反应。结果观察组拔管时长、术后醒来时长均短于对照组,差异有统计学意义(P<0.05);两组失血量、麻醉时长及手术时长比较差异无统计学意义(P>0.05)。观察组术后1 h、4 h、8 h、12 h及24 h VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组T_(0)MAP、HR比较,差异无统计学意义(P>0.05);T_(1)、T_(2)观察组MAP、HR均低于对照组,差异有统计学意义(P<0.05)。两组T_(0)TNF-α、IL-6、GLU及COR水平比较,差异无统计学意义(P>0.05);T_(1)、T_(2)比较,观察组TNF-α、IL-6、GLU及COR水平均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论胃癌根治术患者行全麻联合硬膜外麻醉可降低术后疼痛程度,有效调节TNF-α、GLU及COR水平,可改善炎症、应激反应,且安全性良好。Objective To analyze the effects of general anesthesia combined with epidural anes⁃thesia on inflammation and stress response in patients undergoing radical gastrectomy.Methods 108 cases of gastric cancer patients who underwent radical surgery were admitted to the First People's Hospital of Jintang County from July 2020 to May 2023.They were divided into two groups based on their anesthesia methods:53 cases in the control group(general anesthesia)and 55 cases in the observation group(general anesthesia com⁃bined with epidural anesthesia).The study compared anesthesia⁃related indexes,pain levels,changes in vital signs,inflammation,stress reactions,and adverse reactions between the two groups.Results The length of extubation and postoperative awakening in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the comparison of blood loss,anesthesia duration and operation duration between the two groups(P>0.05).The postoperative VAS scores at 1 h,4 h,8 h,12 h and 24 h in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).When comparing the T_(0) MAP and HR of the two groups,the difference was not statistically significant(P>0.05).The MAP and HR of the obser⁃vation group were lower than those of the control group at T1 and T2,and the difference was statistically sig⁃nificant(P<0.05).Comparing T_(0) TNF⁃α,IL⁃6,GLU and COR levels between the two groups,the difference was not statistically significant(P>0.05);at T1 and T2,TNF⁃α,IL⁃6,GLU and COR levels in the observa⁃tion group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Combining general anesthesia with epi⁃dural anesthesia in patients un

关 键 词：全麻 硬膜外麻醉 胃癌根治术 TNF-α GLU COR 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]