硬膜外麻醉联合全麻对非小细胞肺癌的疗效及围术期免疫功能的影响

目的 探讨硬膜外麻醉联合全麻对非小细胞肺癌患者的疗效以及围术期免疫功能的影响.方法 选择行手术治疗的非小细胞肺癌患者60例,随机分为两组,每组30例,A组患者术中接受硬膜外麻醉联合全身麻醉,B组患者术中接受静脉全麻.比较两组患者的手术以及术后情况,分别评价两组患者术后VAS评分并进行分析,分别检测并分析两组患者围术期免疫功能的变化.结果 A组患者手术时间、术后苏醒时间、术后拔管时间以及恢复自主呼吸时间较B组显著缩短(P＜0.05).术后3h及6 hA组患者的VAS评分显著低于B组患者(P＜0.05);术毕以及术后A组患者的CD4+以及CD4 +/CD8+明显比B组高(P＜0.05);且手术结束后,A组患者血清中白介素-6(IL-6)以及肿瘤坏死因子-α(TNF-α)水平明显较B组低(P＜0.05).结论 硬膜外麻醉联合全麻用于非小细胞肺癌手术可显著改善患者的手术以及术后情况,利于患者术后免疫功能的恢复,缓解患者术后疼痛,值得临床推广应用.

The Curative Effect of Epidural Anesthesia Combined with General Anesthesia for Non-small Cell Lung Cancer and Influence on the Perioperative Immune Function

Objective To explore the curative effect of epidural anesthesia combined with general anesthesia for nonsmall cell lung cancer and influence on the perioperative immune function.Methods 60 patients with non-small cell lung cancer after surgery were enrolled,and were randomly divided into 2 groups,Group A (n =30) accepted epidural anesthesia combined with general anesthesia during operation,and group B (n =30) adopted intravenous anesthesia.The operation and postoperative condition of all patients were compared,the postoperative VAS score of all patients in the 2 groups were evaluated and analyzed;The change of perioperative immune function were detected respectively and analyzed.Results The time of operation,postoperative recovery,postoperative extubation and spontaneous breathing recovery of patients in group A were shorter than group B,and the difference were significant (P ＜ 0.05).In postoperative 3 h and 6 h,the VAS score of patients in group A were lower significantly than group B (P ＜0.05);Mter operation,the CD4+ content and CD4 +/CD8 + of group A were higher significantly than those Group B (P ＜ 0.05);and the serum level of interleukin-6 (IL-6) and tumor necrosis factor a (TNF-α) in group A were lower than group B significantly (P ＜ 0.05).Conclusion Epidural anesthesia combined with general anesthesia for patients with non-small cell lung cancer can improve the operative and postoperative condition,but also contribute the recovery of immunity function and relief postoperative pain,it is worthy of clinical application.