七氟醚对宫颈癌患者围术期血清细胞因子的影响

目的研究七氟醚麻醉对宫颈癌患者围术期血清相关细胞因子的影响。方法将组织学诊断为宫颈癌的患者90例，按手术时采用的麻醉药物的不同随机分为三组：第1组患者为异丙酚组（工组，n=30）；第Ⅱ组患者为七氟醚组（Ⅱ组,n=30）；第Ⅲ组患者为异丙酚＋七氟醚组（Ⅲ组，n=30）；观察麻醉前30min、手术开始后1h、2h、手术结束后1h、24h和48h六个时点患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-8（1L-8）、白细胞介素-10（IL-10）水平的变化。结果三组患者术后血清TNF-α、IL-8、IL-10水平与麻醉前值比较均升高（P〈0．01），一般在术后24h达峰值。比较血清TNF-α、IL-8、IL-10浓度变化，Ⅰ组和Ⅱ组之间差异无统计学意义，Ⅲ组抑制这三种细胞因子释放的能力明显强于Ⅰ组和Ⅱ组（P〈0．05）。结论应用七氟醚或异丙酚进行麻醉维持在宫颈癌手术中，两者控制炎性应激反应的作用类似；七氟醚联合异丙酚进行麻醉维持可更有效地降低术后炎性应激反应。

The effect of the anesthesia performed under sevoflurane on the perioperative serum cytokines in cervical cancer patients

Objective To study the anesthesia performed under sevoflurane on the perioperative serum cytokines in cervical cancer patients. Methods ASA Ⅰ o r Ⅱ patients aged 32-54 yr weighing 58-79 kg were randomly divided into three groups（n = 30 each） ： Propofol group （Group Ⅰ） ; Sevoflurane group （ Group Ⅱ ） and Sevoflurane ol＋ Propof group（GroupⅢ ）. The levels of serum TNF-α,interleukin-8 and interleukin-10 were observed at six time points ：before anesthesia , at 1 and 2 h after the begain of surgery tat 1,24 and 48 h after the end of surgery. Results The levels of serum TNF-α,IL-8 and IL-10 increased significantly after the operation , reached at peak values at 24 h （P〈0.05） ,and then gradually declined but still higher than the baseline values. The serum TNF-α,IL-8and IL-10 were significantly higher at 1,24 and48 h after the end of surgery in group Ⅰ and Ⅱ than those in groupⅢ （P〈 0. 05 ）. Conclusion The anesthesia performed under sevoflurane inhalation combined with propofol during the sur- gery of cervical cancer can more efficiently suppress the inflammatory response to surgery by promoting the increase of anti-inflammatory cytokine.