不同麻醉方法对幕上肿瘤切除术患者术后免疫功能的影响

Effects of different anesthetic methods on postoperative immunity function response in patients undergoing supratentorial craniotomy

目的:通过观察幕上肿瘤切除术患者肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-8、IL-10、Ig M、Ig A及Ig G的水平来探讨电针(EA)及经皮穴位电刺激(TEAS)对免疫功能的影响是否相同。方法:120例患者被随机分成3组:电针组(A组)、经皮穴位电刺激组(B组)、单纯全麻组(C组)。于麻醉前(T0)、诱导后4h(T1)、术后1d(T2)及术后2d(T3)采集外周血来检测TNF-α、IL-8、IL-10、Ig M、Ig A及Ig G的水平。结果:与T0时间点相比,A组和B组的IL-10水平于T2、T3时间点明显升高(P<0.05);A组的IL-8水平于T2、T3时间点明显升高(P<0.05);C组的Ig A水平于T1、T2、T3时间点明显降低(P<0.05)。与A组相比,B组和C组的IL-8水平于T2、T3时间点明显降低(P<0.05),Ig A水平于T1、T2时间点降低程度明显(P<0.05)。结论:EA可以减轻幕上肿瘤切除术患者免疫功能的抑制。TEAS不能减轻幕上肿瘤切除术患者免疫功能的抑制。

Objective： To observe whether electroacupuncture（EA） and transcutaneous electrical acupoint stimulation（TEAS） influencing the postoperative immunity function was equal or not, based on observing the levels of TNF-α, IL-8, IL-10, Ig M, Ig A and Ig G in patients undergoing supratentorial craniotomy. Methods： 120 patients undergoing supratentorial craniotomy were randomly divided into 3 groups： EA group（group A） and TEAS group（group B）, general anesthesia group（group C）, with 40 cases in each group. The peripheral blood was collected to detect the levels of TNF-α, IL-8, IL-10, Ig M, Ig A and Ig G at time of before anesthesia（T0）, 4 hours after being induced（T1）, 1 and 2 days after operation（T2 and T3）, respectively. Results： In group A and group B, the level of IL-10 at T0 was lower than that at T2 and T3（P〈0.05）. In group A, the level of IL-8 at T0 was lower than that at T2 and T3（P〈0.05）. In group C, the level of Ig A at T0 was obviously higher than that at T1, T2 and T3（P〈0.05）. At T2 and T3, the level of IL-8 in group A was both higher than that in group B and group C（P〈0.05）. At T1 and T2, the level of Ig A in group A was both higher than that in group B and group C（P〈0.05）. Conclusion： The immunity function was inhibited after undergoing supratentorial craniotomy, which would be relieved by EA rather than TEAS.