摘要
目的:分析全麻复合硬膜外麻醉对老年宫颈癌患者术中血压控制及术后血清单核细胞趋化蛋白-1(MCP-1)、谷胱甘肽过氧化物酶(GSH-Px)水平变化的影响。方法:选取2014年3月至2017年3月我院老年宫颈癌患者68例,随机数字表法分为观察组(34例)和对照组(34例)。两组均采取腹腔镜手术治疗,观察组予全麻复合硬膜外麻醉,对照组予全身麻醉。比较两组的麻醉效果、不良反应发生率、血压[收缩压(SBP)、舒张压(DBP)]、心率与手术前后血清MCP-1、GSH-Px水平。结果:观察组吸入异氟醚剂量较对照组减少,自主呼吸恢复及清醒时间较对照组缩短,差异有统计学意义(P<0.05);观察组麻醉优良率94.12%(32/34)高于对照组76.47%(26/34)(P<0.05);两组麻醉前SBP、DBP、心率比较,差异无统计学意义(P>0.05),观察组麻醉诱导后、气腹创建后、手术结束时的SBP、DBP、心率均低于对照组(P<0.05);两组术前血清MCP-1、GSH-Px水平比较,差异无统计学意义(P>0.05),观察组术后血清MCP-1水平低于对照组,血清GSH-Px水平高于对照组(P<0.05);观察组不良反应发生率5.88%(2/34)低于对照组26.47%(9/34)(P<0.05)。结论:老年宫颈癌患者术中采取全麻复合硬膜外麻醉效果显著,可明显控制患者血压、心率变化情况,改善其血清MCP-1、GSH-Px水平,缓解氧化应激及炎症反应,促进其恢复,且不良反应少。
Objective: To analyze the effects of general anesthesia combined with epidural anesthesia on intraoperative blood pressure control and serum monocyte chemoattractant protein-1( MCP-1),glutathione peroxidase( GSH-Px) levels in elderly patients with cervical cancer. Methods: From March 2014 to March 2017,68 patients with cervical cancer in our hospital were randomly divided into observation group( 34 cases) and control group( 34 cases). The two groups were treated with laparoscopic surgery,the observation group was given general anesthesia combined with epidural anesthesia,the control group was given general anesthesia. The anesthetic effect,incidence of adverse reactions,blood pressure [systolic blood pressure( SBP),diastolic blood pressure( DBP) ],heart rate and serum MCP-1 and GSH-Px levels before and after operation were compared between the two groups. Results: The inhalation isoflurane dose in the observation group was lower than that in the control group,and the spontaneous respiration recovery and awake time were shorter than the control group( P < 0. 05). The excellent and good rate of anesthesia in the observation group( 94. 12%,32/34) was higher than that in the control group( 76. 47%,26/34)( P < 0. 05). There was no significant difference in SBP,DBP and heart rate between the two groups before anesthesia( P > 0. 05),the SBP,DBP and heart rate after anesthesia induction,after pneumoperitoneum was created,at the end of surgery in the observation group were significantly lower than that in the control group( P < 0. 05). There was no significant difference in the serum MCP-1 and GSH-Px levels between the two groups before operation( P > 0. 05),but after operation,the serum MCP-1 level in theobservation group was lower than that in the control group,and the serum GSH-Px level was higher than that of the control group( P <0. 05). The incidence of adverse reactions in the observation group( 5. 88%,2/34) was lower than that in the control group( 26. 47%,9/34)( P < 0. 05). Conclusion: The effect of general anesthesia combined with epidural anesthesia in elderly patients with cervical cancer is significant,which can significantly control the blood pressure and heart rate change,improve the serum MCP-1 and GSH-Px levels,alleviate oxidative stress and inflammatory response,promote its recovery,and less adverse reactions.
出处
《中国医药导刊》
2017年第12期1275-1279,共5页
Chinese Journal of Medicinal Guide
基金
陕西省科学技术应用课题项目(项目编号:1300271502
项目名称:硬膜外腔穿刺成功后置管困难临床研究)
关键词
宫颈癌
腹腔镜手术
全麻复合硬膜外麻醉
血压控制
MCP-1
GSH-PX
Cervical cancer
Laparoscopic surgery
General anesthesia combined with epidural anesthesia
Blood pressure control
MCP-1
GSH-Px
