不同麻醉方法对老年直肠癌根治术患者血清VEGF-C及PGE2的影响

目的:探讨不同麻醉及镇痛方法对老年直肠癌根治术患者血清血管内皮生长因子C（vascular endothelial growth factor C，VEGF-C）及前列腺素E2（prostaglandin E2，PGE2）的影响。方法:按照随机数字表法，将纳入的86例患者随机分为A组43例与B组43例。A组患者采用全身麻醉，且于术后实施自控静脉镇痛；B组患者采用硬膜外阻滞复合全身麻醉，且于术后实施自控硬膜外镇痛。比较两组麻醉效果，术后3 h、术后12 h及术后24 h患者VAS评分，及术前和术后3 d患者血清VEGF-C和PEG2含量变化。结果:B组麻醉优良率（100.00%）高于A组（86.05%），且有统计学差异（P＜0.05）；B组术后3 h、术后12 h及术后24 h患者VAS评分低于低于同期A组（P＜0.05）；两组术后3 d患者血清VEGF-C和PEG2含量降低（A组:t=35.450 0、7.789 3,B组:t=67.800 6、15.495 2，P＜0.05）；B组术后3 d患者血清VEGF-C和PEG2含量低于A组（t=34.095 1、7.711 9，P＜0.05）。结论:采用硬膜外阻滞复合全身麻醉及术后实施自控硬膜外镇痛对老年直肠癌根治术患者麻醉效果良好，镇痛效果良好，降低血清VEGF-C和PEG2含量，具有重要研究价值。

Effects of different methods of anesthesia and analgesia on serum vascular endothelial growth factor C and prostaglandin E2 in elderly patients undergoing radical resection of rectal cancer

Objective:To investigate the effects of different methods of anesthesia and analgesia on serum vascular endothelial growth factor C (VEGF-C) and prostaglandin E2 (PGE2) in elderly patients undergoing radical resection of rectal cancer.Methods:According to the random number table method,86 patients were randomly divided into A group (n=43) and B group (n=43).Patients in A group received general anesthesia,and postoperative patient-controlled intravenous analgesia，B group patients with epidural block combined with general anesthesia,and postoperative patient-controlled epidural analgesia.The anesthetic effect,postoperative 3 h,postoperative 12 h and postoperative 24 h score of two groups of patients,and the changes of serum VEGF-C and PEG2 levels before and postoperative 3 d were compared between the two groups,and the results were compared between the two groups after VAS.Results:B group anesthesia excellent rate (100%) was higher than that of A group (86.05%) (P＜0.05).B group postoperative 3 h,12 h and 24 h after operation in patients with VAS were lower than those of lower than those in A group (P＜0.05).3 d patients with serum VEGF-C and PEG2 content decreased by two after surgery (A group:t=35.450 0,7.789 3,B group:t=67.800 6,15.495 2,P＜0.05).In the B group postoperative 3 d serum VEGF-C and PEG2 were lower than the A group (t=34.095 1,7.711 9,P＜0.05).Conclusion:The use of epidural anesthesia and general anesthesia surgery after implementation of patient-controlled epidural analgesia in elderly patients undergoing surgery for rectal cancer has good anesthesia effect,good analgesic effect,reduce serum VEGF-C and PEG2 content,has the important research value.