不同麻醉方法对结直肠癌根治术患者应激免疫反应的影响分析

目的：分析不同麻醉方法的运用对结直肠癌根治术患者应激免疫反应的影响。方法：选取120例结直肠癌根治术患者，依照入院顺序随机均分为四组，分别予以丙泊酚静脉全麻复合硬膜外（PRO＋EPI）、七氟烷吸入全麻复合硬膜外（SEV＋EPI）、丙泊酚静脉全麻（PRO）、七氟烷吸入全麻（SEV）处理；对照四组各阶段白细胞内丙酮酸激酶（PK）、葡萄糖6-磷酸脱氢酶（G-6PD）活性变化。结果：PRO组各阶段的白细胞PK活性、G-6PD活性对比均无明显变化（P〉0.05）。除PRO组之外的三组T3、T4期白细胞PK活性均明显高于T1期、G-6PD活性均明显低于T1期；PRO＋EPI组、SEV＋EPI组T4期白细胞PK活性明显低于T3期、G-6PD活性明显高于T3期，差异均有统计学意义（P〈0.05）。结论：吸入全麻复合硬膜外（SEV＋EPI）、静脉全麻复合硬膜外（PRO＋EPI）两种麻醉方式下患者直肠癌根治术过程中会出现白细胞代谢增强现象，但术后24 h内白细胞代谢逐渐回落，表明此两种麻醉方式不会对应激免疫反应产生过大刺激；单纯静脉全麻（PRO）中2项指标调控效果不明显，表明麻醉对白细胞代谢刺激较大而得不到调控，应激免疫反应影响最大。

Different Anesthesia Methods on the Influence of the Immune Response in Patients with Colorectal Cancer Radical Stress

Objective：To explore the effect of the use of different anesthesia methods on the immune response of the patients with colorectal cancer radical stress.Method：120 patients with colorectal cancer radical were randomly divided into 4 groups according to admission order. And 4 groups were treated by propofol intravenous general anesthesia compound epidural＋EPI（PRO）,sevoflurane inhalation anesthesia compound epidural＋EPI（SEV）,propofol intravenous anesthesia （PRO）,sevoflurane inhalation anesthesia（SEV）processing,the different stages of the four groups of white blood cells within the pyruvate kinase（PK）,glucose 6 phosphate dehydrogenase（G-6PD）activity changes were compared.Result：The treatment group was better than the control,there was statistical significance（P〈0.05）. Patients with PRO group of white blood cells in different stages of the PK activity and G-6PD activity were not changed significantly（P〉0.05）. Except PRO group,T3,T4 leucocyte PK activity of three other groups were significantly higher than T1 phase,G-6PD activity were significantly lower than the T1 phase;The leucocyte PK activity of stage T4 in the PRO＋EPI group and SEV＋EPI group were obviously lower than that of stage T3,G-6PD activity of stage T4 was significantly higher than that of stage T3（P〈0.05）. Conclusion：Inhaled general anesthesia compound epidural＋EPI（SEV）,intravenous general anesthesia compound epidural group（PRO＋EPI）under two kinds of anesthesia appear in the process of white blood cells in patients with colorectal cancer radical metabolism enhance phenomenon,but gradually subside within 24 h after white blood cells metabolism,show that the two kinds of anesthesia to stress the body＇s immune response to excessive stimulus;Simple intravenous anesthesia（PRO） 2 indicators in the control effect is not apparent,suggest that stimulation anaesthesia in white blood cell metabolism and get larger regulation,stress the immune response.