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目的 :研究单纯全身麻醉和硬膜外复合全身麻醉在结肠癌腹腔镜根治术中的作用和影响。方法:选取2015年10月至2017年1月于平顶山第一人民医院接受腹腔镜根治术治疗的结肠癌患者,采用随机数字表法将全部患者分为治疗组和对照组,治疗组采用硬膜外复合全身麻醉,对照组采用单纯全身麻醉,观察不同麻醉方式对手术的影响。结果:两组患者的手术时间、术中出血量、术中输注晶体液量以及胶体液量差异无统计学意义(P>0.05),对照组术中维持麻醉所吸入的七氟醚平均密度明显高于治疗组,治疗组患者的VAS疼痛评分(1.58±0.97)低于对照组(3.22±1.07),差异有统计学意义(P<0.05);术后1 d时治疗组CD_3~+和CD_4~+两项指标高于对照组,在术后3 d时治疗组CD_4~+/CD_8~+高于对照组,差异有统计学意义(P<0.05);切片后2 h、手术结束时和术后1 d时,治疗组IL-6均高于对照组,差异有统计学意义(P<0.05)。结论:硬膜外复合全身麻醉相对于单纯全身麻醉,在临床结肠癌腹腔镜根治术中,对患者围手术期的细胞免疫功能造成的影响更小,能有效减少患者术后的免疫损伤。
Objective: To investigate the effect and effect of general anesthesia and epidural anesthesia on laparoscopic radical mastectomy for colon cancer. Methods: The patients with colon cancer undergoing laparoscopic radical mastectomy in Pingdingshan First People’s Hospital from October 2015 to January 2017 were randomly divided into treatment group and control group by random number table method. The treatment group was treated with dura mater External composite general anesthesia, the control group with simple general anesthesia, observation of different anesthesia on the impact of surgery. Results: The operation time, intraoperative blood loss, amount of intraoperative fluid infusion and colloid fluid volume were not significantly different between the two groups (P> 0.05). The mean sevoflurane inhalation anesthesia in the control group (1.58 ± 0.97) in the treatment group was significantly lower than that in the control group (3.22 ± 1.07), the difference was statistically significant (P <0.05); on the first day after operation, the CD_3 ~ + The CD_4 ~ + index of two groups was higher than that of the control group, and the level of CD_4 ~ + / CD_8 ~ + in the treatment group was higher than that of the control group 3 d after operation (P <0.05); at 2 h after the operation, And 1 d after operation, the levels of IL-6 in the treatment group were significantly higher than those in the control group (P <0.05). Conclusion: Compared with simple general anesthesia, epidural combined general anesthesia has less effect on perioperative cellular immune function in clinical colon cancer laparoscopic radical surgery and can effectively reduce postoperative immune damage.