全麻复合硬膜外麻醉方式对肺癌患者术后肾上腺皮质、应激因子、免疫水平的影响

Influence of general anesthesia combined with epidural anesthesia on adrenal cortex,stress factors and immunologic function in patients with lung cancer

目的:研究分析全麻复合硬膜外麻醉方式对肺癌患者手术治疗后肾上腺皮质、应激因子、免疫水平的影响。方法:选取60例肺癌患者随机分为对照组和观察组,各30例。两组在行肺癌根治术之前,对照组给予全身麻醉,观察组在对照组的基础上复合硬膜外麻醉。记录比较患者手术治疗前后血清Ang-Ⅱ、Cor、AD、MDA、GC、ALDO、17-OH、17-KS水平及T细胞亚群水平。结果:(1)治疗前,两组患者Ang-Ⅱ、Cor、AD、MDA、GC、ALDO、17-OH、17-KS水平之间差异无统计学意义(P>0.05);治疗后,与同组治疗前相比,两组患者Ang-Ⅱ、Cor、AD、MDA、GC、ALDO、17-OH、17-KS水平均明显降低,差异具有统计学意义(P<0.05),且观察组患者Ang-Ⅱ、Cor、AD、MDA、GC、ALDO、17-OH、17-KS水平降低程度均明显优于对照组,两组之间差异具有统计学意义(P<0.05)。(2)治疗前,两组患者CD4^+、CD8^+和CD4^+/CD8^+之间差异无统计学意义(P>0.05);治疗后,与同组治疗前相比,两组患者CD4^+、CD4^+/CD8^+均显著降低,CD8^+显著升高,差异均有统计学意义(P<0.05),且观察组患者CD4^+、CD4^+/CD8^+降低程度和CD8^+升高程度均明显低于对照组,两组之间差异具有统计学意义(P<0.05)。结论:对肺癌患者术前使用全麻复合硬膜外麻醉,可改善患者肾上腺皮质、应激因子水平,减轻患者免疫功能的损伤,具有良好的免疫保护作用。

Objective:To observe the influence of general anesthesia combined with epidural anesthesia on adrenal cortex,stress factors and immunologic function in patients with lung cancer.Methods A total of 60 patients with lung cancer were randomly divided into two groups:observation group(30 cases)and control group(30 cases).Observation group:general anesthesia combined with epidural anesthesia;control group:patients were treated only by general anesthesia.Recording and comparing the levels of Ang-Ⅱ,Cor,AD,MDA,GC,ALDO,17-OH,17-KS and immunologic function before and after treatment.Methods:Results:(1)Before treatment,there was no statistically significant difference in the serum Ang-Ⅱ,Cor,AD,MDA,GC,ALDO,17-OH,17-KS levels between the two groups(P>0.05).After treatment,the serum Ang-Ⅱ,Cor,AD,MDA,GC,ALDO,17-OH,17-KS levels of the two groups were significantly lower than those of the same group before treatment(P<0.05),and those levels of observation group were significantly better than the control group,there was significant difference between the two groups(P<0.05).(2)Before treatment,there was no statistically signify cant difference in CD4^+,CD8^+,CD4^+/CD8^+between the two groups(P>0.05).After treatment,the CD4^+,CD4^+/CD8^+of the two grou ps were significantly lower than those of the same group before treatment(P<0.05),the CD8^+of the two groups were significantly higher(P<0.05),and those levels of observation group were significantly better than the control group,there was significant difference between the two groups(P<0.05).Conclusions:General anesthesia combined with epidural anesthesia fosr patients with lung cancer can perfect the levels of serum adrenal cortical hormone,stress factors and be beneficial to protect their immunologic function.