摘要
目的:分析不同浓度七氟醚对腹腔镜直肠癌切除术患者血浆皮质醇、血管稳定性的影响。方法:将96例直肠癌患者随机分为A组、B组和C组,每组32例。3组患者均气管插管全麻,行腹腔镜直肠癌切除术治疗。A组使用0.5 MAC、B组1.0MAC、C组1.4MAC。比较3组患者血管稳定性指标,血浆皮质醇(Cor)、干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平、各项时间指标及复苏效果。结果:拔管即刻、拔管5min,3组患者HR比较差异有统计学意义(P<0.05)。在拔管15min,3组患者HR比较差异无统计学意义(P>0.05)。拔管5min、15min,3组患者MAP、SPO_(2)比较差异无统计学意义(P>0.05)。麻醉诱导前,3组患者血浆Cor、IFN-γ、IL-4水平比较差异无统计学意义(P>0.05)。术后4h,3组患者血浆Cor、IFN-γ水平高于麻醉前(P<0.05),IL-4水平低于麻醉诱导前(P<0.05)。术后4h,3组患者血浆Cor、IFN-γ、IL-4水平比较差异有统计学意义(P<0.05)。3组患者麻醉时间、苏醒时间比较差异无统计学意义(P>0.05),自主呼吸恢复时间、拔管时间比较差异有统计学意义(P<0.05)。结论:0.5MAC、1.0MAC、1.4 MAC七氟醚均能维持腹腔镜直肠癌切除术患者血管稳定性,其中1.4MAC在拔管时间、苏醒时间、炎症反应、应激反应等方面有优势,建议使用。
Objective To analyse the influences of sevoflurane at the three concentrations on the plasma cortisol and angio-stability of the patients undergoing laparoscopic resection for rectal cancer.Methods Randomly divided 96rectal cancer patients treated in author’s hospital into group A,B and C,32cases per group;all patients received laparoscopic resection for rectal cancer under general anesthesis via endotracheal intubation;group A,B,and C rospectively used 0.5,1.0,and 1.4(MAC);then compared three groups’angio-stability’s norms;the levels of Cor,IFN-γand IL-4;every time norms;and resuscitation efficacy.Results On the time of extubation and afterward 5min in HR there was statistical difference between the three groups(P<0.05),but afterward 15min,did not so(P>0.05);afterward 5min and 15min in MAP and SPO_(2)there was no statistical difference(P>0.05)between the three groups;before anesthesis induction in the levels of Cor,IFN-γand IL-4there was no statistical difference between the three groups(P>0.05);4hafter surgery the Cor and IFN-γlevels of the three groups were higher than that before anesthesis(P<0.05),but IL-4level lower than that before anesthesis induction(P<0.05);4hafter surgery the levels of Cor,IFN-γand IL-4in the three groups had statistical difference;in the time of anesthesis and emergence there was no statistical difference between the three groups(P>0.05),but in the time for autorespiration and for extubation there was statistical difference between the three groups(P<0.05).Conclusion The three concentrations of MAC can all maintain angio-stability,especially,1.4 MAC more has advantages in extubation time,emergence time,inflammatory response,and stress response,etc.
作者
杨柳
YANG Liu(Division of Anesthesis and Perioperative Medical Surgery,the First Affiliated Hospital to Nanyang Medical College for Professional Training,Nanyang,Henan 473000)
出处
《中国肛肠病杂志》
2022年第7期15-18,共4页
Chinese Journal of Coloproctology
关键词
腹腔镜直肠癌切除术
血浆
皮质醇
血管稳定性
七氟醚
Laporoscopic resection surgery for rectal cancer
Plasma
Cortisol
Angio-stability
Sevoflurane
