七氟醚和丙泊酚对行腹腔镜宫颈癌根治术患者炎症因子及应激反应的影响

目的 腹腔镜宫颈癌根治术是常见的妇科癌症手术,但手术对机体造成损伤,本研究探讨七氟醚和丙泊酚对行腹腔镜宫颈癌根治术患者炎症因子及应激反应的影响。 方法 选取2015年2月-2016年8月于浙江省肿瘤医院择期行腹腔镜宫颈癌根治术患者90例,随机对照表法分为观察组和对照组。观察组45例,行七氟醚吸入麻醉;对照组45例,行丙泊酚静脉输注麻醉。观察2组患者麻醉时间、自主呼吸恢复时间、睁眼时间、言语应答时间、定向力恢复时间、拔管时间,并进行记录。采用酶联免疫吸附法检测炎症因子肿瘤坏死因子(TNF-α)、白介素1β(IL-1β)水平,采用血压监测仪监测心率(HR)、平均动脉压(MAP),采用血糖仪检测血糖(GLU),采用放射免疫法检测皮质醇(COR)、血管紧张素Ⅱ(AngⅡ)水平,观察2组患者麻醉前(T0)、气腹后10 min(T1)、手术后10min(T2)上述指标变化情况。 结果 观察组自主呼吸恢复时间、睁眼时间、言语应答时间、定向力恢复时间、拔管时间均明显低于对照组(P<0.05);2组患者T1、T2时TNF-α、IL-1β均较T0时显著升高(P<0.05),但观察组TNF-α、IL-1β明显低于对照组(P<0.05);2组患者各时点HR、MAP差异均无统计学意义(P>0.05),2组患者T1、T2时GLU、CRO、AngⅡ均较T0时显著升高(P<0.05),但观察组T1、T2时GLU、CRO、AngⅡ明显低于对照组(P<0.05);观察组不良反应率为13.33%,对照组不良反应率为11.11%,2组不良反应发生率差异无统计学意义(χ2=0.104,P>0.05)。 结论 七氟醚麻醉效果较好,可抑制手术产生的炎症反应和应激反应。 

Affection of sevoflurane and propofol on inflammatory factors and stress response in patients with cervical cancer after laparoscopic radical hysterectomy

Objective The laparoscopic radical hysterectomy for cervical cancer is a common gynecological cancer surgery,but surgery can lead to body damage,this study aims to investigate the effect of sevoflurane and propofol on and stress response in patients with cervical cancer after laparoscopic radical hysterectomy. Methods A total of 90 patients undergoing laparoscopic radical hysterectomy for cervical cancer from February,2015 to August,2016 were divided into observation group (45 cases) and control group (45 cases).The patients of the control group,received sevoflurane inhalation anesthesia;The patients of the observation group,received propofol intravenous anesthesia.The anesthesia duration and the time to spontaneous breathing recovery,eye opening,speech response,orientation recovery and extubation were observed.The enzyme-linked immunosorbent method was used to detect inflammatory factor tumor necrosis factor (TNF-α) and beta interleukin 1(IL-1β) level,the blood pressure monitor was used to monitor the heart rate (HR) and mean arterial pressure (MAP),the glucose meter was used to monitor the level of glucose (GLU),the radioimmunoassay was used to detect the levels of cortisol (COR) and angiotensin Ⅱ(AngⅡ).The changes of the above indexes at T0(before the anesthesia),T1(10 min after pneumoperitoneum) and T2(10 min after the surgery) were compared between the two groups. Results The time to spontaneous breathing recovery,eye opening,speech response,orientation recovery and extubation in the observation group were significantly shorter than those in the control group (P<0.05);Compared with T0,the levels of TNF-α and IL-1β was increased significantly at T1 and T2 in both groups (P<0.05);but the levels of TNF-α and IL-1β of observation group was lower than those in control group (P<0.05);There was no significant difference in HR and MAP at each time point between the two groups (P>0.05);The levels of GLU,CRO and AngⅡ at T1 and T2 were significantly higher than those at T0 in 2 groups (P<0.05),but the levels of GLU,CRO and AngⅡ of observation group was lower than those in control group (P<0.05);Incidence of adverse reactions of the observation group was 13.33%,and of the control group was 11.11%,the difference was not significant (χ2=0.104,P>0.05). Conclusion The clinical effect of sevoflurane anesthesia is good,which can inhibit the inflammatory reaction and stress reaction in patients with laparoscopic radical hysterectomy for cervical cancer.