七氟醚对宫颈癌患者围术期血清细胞因子的影响

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

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。

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.