规范化硬膜外阻滞复合全麻对老年卵巢癌细胞减灭术患者的影响  

Effect of Standardized Epidural Block Combined with General Anesthesia on Senile Patients with Ovarian Cancer Cell Reduction

作　　者：胡茜茜 许晓燕 杨建美 郭立君 HU Qian-qian;XU Xiao-yan;YANG Jian-mei;GUO Li-jun(Gynecology and obstetrics,The First People's Hospital of Lanzhou City;Anesthesiology department,The First People's Hospital of Lanzhou City;Gansu University of Traditional Chinese Medicine Second Clinical School)

机构地区：[1]兰州市第一人民医院妇产科 [2]兰州市第一人民医院麻醉科 [3]甘肃中医药大学第二临床医学院

出　　处：《中国标准化》2024年第22期289-292,共4页China Standardization

基　　金：甘肃省科技计划项目甘肃省自然科学基金项目“罗哌卡因硬膜外阻滞复合全麻对老年卵巢癌细胞减灭术患者应激、免疫指标的影响”(项目编号:23JRRA1455);甘肃省科技计划项目甘肃省自然科学基金项目“MPO、ER、PR在子宫内膜息肉中的表达及临床意义”(项目编号:24JRRA766)资助。

摘　　要：目的:探讨规范化硬膜外阻滞复合全麻对老年卵巢癌细胞减灭术应激、免疫指标的影响。方法:选取2022年6月至2023年9月兰州市第一人民医院收治的80例老年卵巢癌患者,分为对照组和观察组,各40例,对照组在手术时实施全麻,观察组进行规范化硬膜外阻滞复合全麻,比较两组麻醉后患者的应激、免疫指标变化情况。结果:观察组术后并发症明显低于对照组(P<0.05);两组诱导前、术毕时HR、MAP水平差异无统计学意义(P>0.05),气管插管、切皮后、手术探查时,观察组明显低于对照组(P<0.05);术后当天、第5天两组炎症因子水平无明显差异(P>0.05),术后1天、术后3天观察组炎症因子水平明显高于对照组(P<0.05)。结论:对于进行细胞减灭术的老年卵巢癌患者实施规范化硬膜外阻滞复合全麻的麻醉方式,患者术后并发症发生率相对较低,围手术期间血流动力学保持平稳,并且能减轻患者术后免疫功能的抑制。Objective:To investigate the effects of standardized epidural block combined with general anesthesia on the stress and immune indexes of senile ovarian cancer cells.Methods:80 elderly patients with ovarian cancer treated in the First People’s Hospital of Lanzhou City from June 2022 to September 2023 were selected and divided into the control group and the observation group,with 40 cases in each group.The control group received general anesthesia during operation,and the observation group received standardized epidural block combined with general anesthesia.The changes of stress and immune indexes of the patients after anesthesia were compared between the two groups.Results:The postoperative complications in the observation group were significantly lower than those in the control group(P﹥0.05).There was no significant difference in HR and MAP levels between the two groups before induction and after operation(P﹥0.05).The levels in the observation group were significantly lower than those in the control group after endotracheal intubation,skin resection and surgical exploration(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups on the day and day 5 after surgery(P﹥0.05).The levels of inflammatory factors in the observation group were significantly higher than those in the control group on the day 1 and 3 after surgery(P<0.05).Conclusion:The standardized epidural block combined with general anesthesia for elderly ovarian cancer patients undergoing cell reduction surgery has a relatively low incidence of postoperative complications and stable hemodynamics during perioperative period,which can alleviate the suppression of postoperative immune function in patients.

关 键 词：老年卵巢癌 细胞减灭术 硬膜外阻滞复合全麻 

分 类 号：R614[医药卫生—麻醉学] R737.31[医药卫生—外科学]