摘要
目的不同麻醉方法用于肝切除术联合术中RFA对应激反应的影响。方法选取采用肝切除术联合术中RFA治疗的肝癌患者146例为研究对象,随机分为全麻组和复合组,每组各73例,分别采用静脉全麻和静脉全麻复合硬膜外麻醉法进行手术。以患者麻醉前(T0)、手术后(T3)、手术后1 d(T4)、手术后3 d(T5)的CRP,麻醉前(T0)、腹腔探查(T1)、切除完毕(T2)、手术结束(T3)的血糖、乳酸和麻醉前(T0)、腹腔探查(T1)、手术结束(T3)的皮质醇为评价指标。结果与T0时间比,全麻组和复合组患者术后、术后1天、术后3天血液CRP均明显高于麻醉前(P<0.05);T2、T3时点2组的血糖均升高(P<0.05);T1时点2组的乳酸均降低(P>0.05);T1时间点2组的皮质醇均降低(P<0.05),复合组T3时点的皮质醇升高(P<0.05)。2组间比较,复合组术后、术后1天、术后3天血液CRP显著低于全麻组(P<0.05);复合组T2和T3时点的血糖低于全麻组(P<0.05)。结论静脉全麻复合硬膜外麻醉可以减轻肝切除术联合术中RFA肝癌患者应激反应,促进患者免疫系统的恢复,是较适合肝切除术联合术中RFA肝癌患者的麻醉方法。
Objective To study the effects of different anesthesia methods in hepatectomy combined with intraoperative RFA on stress response.Methods A total of 146 patients with hepatocellular carcinoma who underwent hepatectomy combined with intraoperative RFA were enrolled.They were randomly divided into the general anesthesia group and the composite group,with 73 cases in each group.They were treated with intravenous anesthesia and intravenous anesthesia combined with epidural anesthesia.The procedure was performed.Before the patient was anesthetized(T0),postoperatively(T3),1 d after surgery(T4),3 days after surgery(T5),CRP,pre-anesthesia(T0),abdominal exploration(T1),resection completed(T2),Cortisol at the end of surgery(T3),blood glucose,lactic acid,pre-anesthesia(T0),abdominal exploration(T1),and end of surgery(T3)were evaluated.Results Compared with T0 time,the blood CRP of patients in the general anesthesia group and the composite group were significantly higher than that before anesthesia(P<0.05).The blood glucose of group 2 was increased at T2 and T3.High(P<0.05);lactic acid decreased in group 2 at T1(P>0.05);cortisol decreased in group T at time T1(P<0.05),and cortisol increased in group T3 at daytime(P<0.05)<0.05.Compared with the 2 groups,the blood CRP was significantly lower in the composite group than of the general anesthesia group(P<0.05).The blood glucose in the composite group was lower than that of the general anesthesia group(P<0.05).Conclusion Combined general anesthesia with intravenous anesthesia can alleviate the stress response of hepatic resection combined with intraoperative RFA liver cancer patients and promote the recovery of immune system.It is an anesthetic method suitable for hepatectomy combined with intraoperative RFA liver cancer patients.It is worthy of clinical promotion.
作者
史立洁
李宝强
王凯
SHI Lijie;LI Baoqiang;WANG Kai(Zibo Center Hospital,Zibo,255036)
出处
《实用癌症杂志》
2020年第1期124-126,共3页
The Practical Journal of Cancer
关键词
肝切除术
术中RFA
肝癌
不同麻醉方法
应激反应
Liver resection
Intraoperative RFA
Liver cancer
Different anesthesia methods
Stress response
