不同麻醉方式对脊柱结核患者围手术期炎性因子及应激因子 表达的影响

Effect of different anesthesia methods on the expression of inflammatory factors and stress factors in patients with spinal tuberculosis during perioperative period

目的:探讨分析经不同麻醉方式对脊柱结核患者围手术期炎性因子及应激因子表达的影响。方法:系统性分析我院2014年1月至2016年1月脊柱骨病科收治的脊柱结核患者,筛选出其中进行手术清除病灶的患者86例,根据患者病情将其分为A组与B组,其中A组43例,采用硬膜外阻滞联合静脉麻醉的方式,剩余43例为B组仅采用静脉麻醉的方式,分析两组患者围手术期血清白细胞介素1(IL-1)、白细胞介素6(IL-6)及白细胞介素10(IL-10)含量。结果:两组患者血清中IL-1β、IL-6含量从T0期至T3期逐渐上升,在T3期达到顶峰,T4期开始下降,其中两组患者血清中IL-6和IL-10含量从T1至T4期水平均明显高于该组T0期水平,差异均具有统计学意义(P<0.05)。两组间比较可以发现,A组患者在T2期和T3期血清中IL-1β和IL-6含量均明显低于B组,而A组患者在T2期至T4期血清中IL-10含量均明显高于B组,差异均具有统计学意义(P<0.05)。结论:硬膜外阻滞复合静脉全身麻醉相比于单纯静脉麻醉,有助于减轻患者体内炎症反应,改善手术后患者预后,值得在临床上推广。

Objective：To investigate the effects of different anesthesia methods on the expression of inlfammatory factors and stress factors in patients with spinal tuberculosis during perioperative period. Methods：A systematic analysis of spinal tuberculosis patients in our hospital from January 2014 to 2016 January was carried out. 86 cases of patients who underwent surgical removal of the lesion were included in this study. All of the patients were divided into group A and group B according to the condition of the them, in which a group of 43 cases used epidural block combined with intravenous anesthesia and the remaining 43 cases as group B only in intravenous anesthesia way. Serum levels of perioperative IL-1, IL-6 and IL-10 were analyzed in two groups of patients. Results：The serum levels of IL-1 and IL-6 in the two groups increased gradually from T0 phase to T3 phase, and reached the peak in the period of T3, and T4 period began to decrease. The serum levels of IL-6 and IL-10 in the two groups were significantly higher than that in the T4 phase, and the difference was statistically significant （P〈0.05）. The levels of T1 and T0 in the serum of the groups were significantly higher than that in the group. Between the two groups comparison can be found, a group of patients in the T2 and T3 in serum IL-1 beta and IL-6 levels were significantly lower than those in group B, and group A patients in stage T2 to T4 in serum IL-10 levels were significantly higher than those of the group B, the difference is statistically significant （P〈0.05）. Conclusion： Compared with intravenous anesthesia, epidural anesthesia combined with intravenous anesthesia can help to reduce the inflammatory reaction and improve the prognosis after surgery, which is worth promoting in clinical practice.