摘要
目的探讨两种不同麻醉方式对直肠癌并发感染患者围术期细胞免疫功能和感染控制的影响,为直肠癌感染患者选择合适的麻醉方式,为提高直肠癌感染患者临床治疗效果提供参考依据。方法选取2012年6月-2015年6月在医院接受手术治疗的60例直肠癌感染的患者作为研究对象,随机分成对照组和观察组各30例,对照组患者采用腰硬联合麻醉,观察组患者采用全身麻醉。结果两组患者在手术时间和手术出血量比较,差异无统计学意义;两组患者术前免疫球蛋白IgA、IgG、IgM在T0、T1、T2、T3比较,差异无统计学意义;两组患者麻醉后的IL-6和TNF-α明显高于麻醉前,两组比较差异有统计学意义(P<0.05);麻醉后T细胞亚群中CD3、CD4明显低于麻醉前,观察组降低的幅度明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论腰硬联合麻醉能明显提高患者术后免疫能力,降低术后感染率。
OBJECTIVE To explore the influence of different anesthesia approaches on cellular immune function and control of infections in colorectal cancer patients complicated with infections during perioperative period so as to choose appropriate anesthesia approach for the colorectal cancer patients with infections and improve the clinical therapeutic effect.METHODS A total of 60 colorectal cancer patients with infections who received surgical procedures in the hospital from Jun 2012 to Jun 2015 were recruited as the study objects and randomly divided into the control group and the observation group,with 30 cases in each group.The control group was treated with combined spinal and epidural analgesia,while the observation group was given general anesthesia.RESULTS There was no significant difference in the operation duration or blood loss volume between the two groups of patients.There was no significant difference in the level of preoperative IgA,IgG,or IgM between the two groups of patients at T0,T1,T2,or T3.The levels of IL-6and TNF-αof the two groups of patients were significantly higher after the anesthesia than before the anesthesia（P〈0.05）.As for the T cell subsets,the levels of CD3 and CD4 were significantly lower after the anesthesia than before the anesthesia,the magnitude was reduced significantly greater in the observation group than in the control group（P〈0.05）.CONCLUSION The combined spinal and epidural anesthesia can remarkably boost the postoperative immunity and reduce the incidence of postoperative infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第17期4029-4031,共3页
Chinese Journal of Nosocomiology
基金
贵州省社会发展科技攻关基金资助项目(黔科合SY20113040)
关键词
腰硬联合麻醉
全身麻醉
直肠癌
感染
细胞免疫功能
Combined spinal and epidural anesthesia
General anesthesia
Colorectal cancer
Infection
Cellular immune function
