蛛网膜下腔阻滞麻醉联合硬膜外镇痛对子宫肌瘤患者血清CA125、VEGF-C、PGE2水平变化的影响

Effects of subarachnoid anesthesia combined with epidural analgesia on serum CA125,VEGF-C and PGE2 levels in patients with uterine fibroids

目的探讨蛛网膜下腔阻滞麻醉联合硬膜外镇痛对子宫肌瘤患者血清糖类抗原125(CA125)、血管内皮生长因子C(VEGF-C)、前列腺素E2(PGE2)水平变化的影响。方法选取2013年6月—2015年2月舞钢公司总医院104例UM患者,按照随机数表法分组,各52例。对照组给予全麻联合自控静脉镇痛,观察组给予蛛网膜下腔阻滞麻醉联合硬膜外镇痛。对比两组手术前及术后48 h血清CA125、VEGF-C、PGE2水平,术后随访1年,统计UM复发率。结果手术前,两组血清CA125、VEGF-C、PGE2水平差异无统计学意义(P>0.05),术后48 h,两组各指标水平均有所降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组术后复发率为1.92%(1/52),对照组为11.54%(6/52),组间比较差异无统计学意义(P>0.05)。结论蛛网膜下腔阻滞麻醉联合硬膜外镇痛有利于降低UM患者术后血清CA125、VEGF-C、PGE2水平,对预防UM复发具有重要意义。

Objective To investigate the effects of subarachnoid anesthesia combined with epidural analgesia on serum carbohydrate antigen 125（ CA125）,vascular endothelial growth factor C（ VEGF-C） and prostaglandin E2（ PGE2）levels change in patients with uterine leiomyoma. Methods From January 2013 to February 2015,104 patients with UM were randomly divided into control group and observation group,each group 52 cases. The control group was given general anesthesia combined with controlled intravenous analgesia,and the observation group was given subarachnoid anesthesia combined with epidural analgesia. Serum CA125,VEGF-C and PGE2 levels were compared before and 48 h after operation between the two groups,followed up for 1 year,and the UM recurrence rate was calculated. Results There was no significant difference in serum CA125,VEGF-C and PGE2 between the two groups before operation（ P〈0. 05）,at 48 h after operation,each indicator levels of the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant（ P〈0. 05）; The recurrence rate in the observation group was 1. 92%（ 1/52） and the control group11. 54%（ 6/52）,there was no significant difference between the two groups（ P〈0. 05）. Conclusion Subarachnoid anesthesia combined with epidural analgesia is helpful to reduce the serum CA125,VEGF-C and PGE2 levels in UM patients,which is of great significance to prevent recurrence of UM.