静吸复合麻醉对卵巢癌根治术患者手术相关指标的影响  

Effect of intravenous-inhalation anesthesia on surgery-related indicators of patients undergoing radical operation of ovarian cancer

作　　者：冯珍 陈孝堂 庹金丽 贺礼阳 杨艳 李丽楠 姚玲玲 FENGZhen;CHEN Xiaotang;TUO Jinli;HELiyang;YANGYan;LI Linan;YAO Lingling(Department of Anesthesiology,Jianli People's Hospital,Jianli 433300,Hubei,China;Department of Pain,Affiliated Hospital of Hubei University of Arts and Sciences(Xiangyang Central Hospital),Xiangyang 441021,Hubei,China)

机构地区：[1]监利市人民医院麻醉科,湖北监利433300 [2]湖北文理学院附属医院(襄阳市中心医院)疼痛科,湖北襄阳441021

出　　处：《中国性科学》2024年第6期114-119,共6页Chinese Journal of Human Sexuality

基　　金：湖北省自然科学基金项目(WJ2019A132)。

摘　　要：目的探讨卵巢癌根治术采用静吸复合麻醉(IIA)对患者术中体征、脑氧代谢率及免疫功能的影响。方法选取2021年2月至2022年5月在监利市人民医院进行卵巢癌根治术(ROOC)治疗的76例患者作为研究对象,根据麻醉方式分别纳入TIA组和IIA组,各38例。TIA组进行全凭静脉麻醉(TIA),IIA组进行IIA。比较两组患者准备麻醉前(T_(0))、气管插管后(T_(1))、气管插管后10 min(T_(2))和手术结束(T_(3))时的心率(HR)、平均动脉压(MAP)、脑氧代谢指标[脑血流量/脑氧耗(CBF/CMRO_(2))、脑氧耗/脑糖耗(CMRO2/CMRGlu)和乳酸生成量(ADVL)]及麻醉期的各项指标,比较两组患者T_(0)、T_(3)、术后12 h和术后24 h的T淋巴细胞亚群指标。结果IIA组患者麻醉苏醒时间、恢复自主呼吸时间均显著短于TIA组(P<0.05)。术中两组患者HR和MAP均处于正常波动范围,且无显著差异(P>0.05)。T_(1)、T_(2)、T_(3)时与T_(0)时比较,IIA组患者CBF/CMRO_(2)、CMRO_(2)/CMRGlu、ADVL均显著升高(P<0.05),TIA组患者CBF/CMRO2、ADVL显著升高(P<0.05);IIA组患者CBF/CMRO2、ADVL升高幅度显著小于TIA组(P<0.05),CMRO_(2)/CMRGlu升高幅度显著大于TIA组(P<0.05)。T_(3)、术后12 h和术后24 h,与TIA组相比,IIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平较高(P<0.05);T_(3)和术后12 h,与T_(0)相比,IIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平显著降低(P<0.05);T_(3)、术后12 h和术后24 h,与麻醉前相比,TIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均显著降低(P<0.05)。结论进行IIA的ROOC患者苏醒和恢复自主呼吸用时较短,对脑氧代谢平衡和免疫相关T淋巴细胞亚群影响较小,安全性较高。Objective To investigate the effects of intravenous-inhalation anesthesia(IIA)on intraoperative signs,cerebral oxygen metabolic rate and immune function of patients undergoing radical operation of ovarian cancer(ROOC).Methods A total of 76 patients who underwent ROOC at Jianli People's Hospital from February 2021 to May 2022 were selected as the study subjects,and they were divided into total intravenous anesthesia(TIA)group and IIA group according to the anesthesia method,with 38 patients in each group.The TIA group received TIA,while the IIA group received IIA.The heart rate(HR),mean arterial pressure(MAP),cerebral oxygen metabolism indexes[cerebral blood flow/cerebral oxygen consumption(CBF/CMRO_(2)),cerebral oxygen consumption/cerebral glucose consumption(CMRO_(2)/CMRGlu)and lactic acid production(ADVL)]before anesthesia induction(T_(0)),immediately after endotracheal intubation(T_(1)),10 minutes after endotracheal intubation(T_(2))and at the end of surgery(T_(3))and various indexes of patients during anesthesia were compared between two groups,the T lymphocyte subsets before anesthesia at T_(0),T_(3),12 h after surgery and 24 h after surgery were compared between two groups.Results The anesthesia recovery time and spontaneous respiration recovery time in IIA group were significantly shorter than those in TIA group(P<0.05).During operation,HR and MAP of the two groups were in normal fluctuation range,and there was no significant difference(P>0.05).Compared with CBF/CMRO_(2),CMRO_(2)/CMRGlu,and ADVL at T_(0) of patients in the IIA group were significantly increased at T_(1),T_(2) and T_(3)(P<0.05),and CBF/CMRO2 and ADVL of patients in TIA group were significantly increased(P<0.05).The increase ranges of CBF/CMRO_(2) and ADVL of patients in IIA group were significantly lower than those in the TIA group(P<0.05),and the increase range of CMRO_(2)/CMRGlu was significantly greater than that in TIA group(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)of patients in IIA group were significantly higher than t

关 键 词：卵巢癌根治术 静吸复合麻醉 脑氧代谢率 免疫功能 

分 类 号：R711[医药卫生—妇产科学]