七氟醚对胃癌根治术患者围术期前炎因子的影响

Effect of sevoflurane on pro-inflammatory cytokines in the perioperative period of gastric cancer

目的:研究七氟醚对行胃癌根治术患者围术期前炎因子的影响。方法:30例行胃癌根治术患者随机分为对照组和七氟醚组,每组15例。患者一般资料差异无统计学意义。七氟醚组于麻醉后持续吸入1%七氟醚至手术结束;对照组不采用任何吸入性麻醉药。分别于麻醉后即刻(T1)、腹腔探查即刻(T2)、手术结束即刻(T3)、术后2h(T4)、4h(T5)5个时点抽取深静脉血4mL,酶联免疫吸附试验(ELISA)测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)和白细胞介素8(IL-8)浓度。结果:2组患者T1血浆TNF-α、IL-6、IL-8浓度均在正常范围内,组间比较差异无统计学意义。与T1比较,T2～T5TNF-α、IL-6、IL-8浓度均增高,差异有统计学意义(P<0.05)。与对照组比较,七氟醚组在各个时点(T1～T5)TNF-α、IL-6、IL-8浓度均降低,差异有统计学意义(P<0.05)。结论:在胃癌根治术麻醉中应用七氟醚,可以减轻患者围术期前炎因子水平,对抑制手术过度应激反应有帮助。

Objective： To study the effect of sevoflurane on pro-inflammatory cytokines in gastric cancer surgery. Methods： Thirty patients of gastric cancer were divided into two groups randomly： Control group （n=15）and Sevoflurane group （n=15）. There was no statistically significant difference between two groups in general state of health. In Sevoflurane group, from the beginning of the operation to the end, patiens were given continuously 1% sevoflurane inhalation. Plasma levels of tNF-a、 IL-6、IL-8 were measured at the following moments, immediately after induction of anesthesia（T1）,immediately after intra-abdominal exploration （T2）, immediately after surgery （T3）, 2 h and 4 h after surgery（T4 and T5）. Results： Plasma levels of TNF-a, IL-6, IL-8 were normaland there was no statistically significant difference between two groups in the moment of T1. Compared with T1, the levels increased significantly at T2～T5 in both groups （P〈0.05）.The levels of TNF-a, IL-6, IL-8 in sevoflurane group were significantly lower than those in the control group in the moments of T2, T3, T3, T4, T（5P〈0. 05）. Conclusion： Sevoflurane can effectively inhibit the inflammation response in gastric cancer surgery.