两种不同麻醉方法对胃癌根治术患者围术期免疫功能的影响

目的探讨两种不同麻醉方法对胃癌根治术患者围术期免疫功能的影响。方法将120例择期行胃癌根治术患者随机分入A组(全身麻醉组)和B组(全身麻醉复合硬膜外麻醉),每组各60例。比较两组围术期血清皮质醇、T淋巴细胞亚群,白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平。结果 A组术后2 h至3 d血清皮质醇浓度显著升高(P<0.05),B组未见升高;两组术后IL-6、IL-8均显著升高,CD3、CD4、CD4/CD8显著下降,但A组IL-6、IL-8显著高于B组(P 0.05),A组CD3、CD4、CD4/CD8显著低于B组(P<0.05)。结论全身麻醉复合硬膜外麻醉用于胃癌根治术,可减小应激反应,对麻醉后免疫功能抑制作用小。

Effects of different anesthesia methods on perioperative immune function of patients with gastric cancer undergoing radical resection

Objective To explore the effects of different anesthesia methods on immune function of patients with gastric cancer undergoing radical resection. Methods One hundred and twenty gastric cancer patients undergoing selective radical resection were randomly divided into group A （general anesthesia） and group B （general combined epidural anesthesia） with 60 patients in each group. Cortisol, T lymphocyte subsets, interleukin 6 （ IL - 6） and interleukin 8 （ IL - 8 ） of perioperative period were compared between two groups. Results Serum cortisol level was greatly increased from 2 hour to 3 days after operation in group A （ P 〈 0.05 ）, but no significant change in group B. Serum IL - 6 and IL - 8 were increased and CD3, CIM and CIM/CD8 decreased in both groups; however, serum IL -6 and IL -8 were significantly higher in group A than in group B （ all P 〈 0. 05 ）, CD3, CD4 and CD4/CD8 in group A were significantly lower than in group B （ all P 〈 0.05 ）. Conclusion General combined with epidural anesthesia for gastric cancer undergoing radical resection can decrease stress response with less inhibition for immune function.