七氟醚在肺癌根治术中的应用效果及对血清E-selectin sIL-2R β-EP HMGB1的影响

The Effect of Sevoflurane in Radical Resection of Lung Cancer and its Effect on Serum E-selectin sIL-2R beta-EP and HMGB1

目的:探讨七氟醚在肺癌根治术中的应用效果及对其血清E-选择素(E-selectin)、可溶性白介素2受体(s IL-2R)、β-内啡肽(β-EP)、高迁移率族蛋白B1(HMGB1)的影响。方法:选择2015年3月至2017年3月我院接诊的96例行肺癌根治术的患者,通过随机数表法分为A组(n=48)和B组(n=48)。手术过程中,A组使用1~2%七氟醚维持麻醉,B组使用1~1.5%异氟醚维持麻醉。比较两组围术期情况,T0(手术前)、T1(手术开始1h)、T2(术毕)、T3(术后1h)时血清E-selectin、s IL-2R、β-EP、HMGB1水平的变化、术后躁动发生率及不良反应的发生情况。结果:两组术中出血量、术中输液量、手术时间比较差异均无统计学意义(P>0.05);A组苏醒时间、拔管时间、自主呼吸恢复时间及住院时间均明显短于B组(P<0.05);两组T1、T2、T3时点血清E-selectin、s IL-2R、β-EP、HMGB1水平较T0时点比较均显著升高(P<0.05),A组在T1、T2、T3时点血清E-selectin、s IL-2R、β-EP、HMGB1水平均明显低于B组(P<0.05);A组术后躁动发生率明显低于B组(P<0.05);A组术后不良反应发生率明显低于B组(P<0.05)。结论:在肺癌根治术中使用七氟醚的麻醉效果显著,可显著降低血清E-selectin、s IL-2R、β-EP、HMGB1的表达,降低术后躁动及不良反应发生率,促进术后恢复。

Objective:To study the anesthetic effect of sevoflurane in the treatment of radical procedure for lung cancer and its effects on the serum E-selectin,Soluble interleukin 2 receptor(sIL-2R),β-endorphin(β-EP)and high mobility group box protein B1(HMGB1)levels.Methods:96 cases of lung cancer patients undergoing radical procedure who were treated from March 2015 to March 2017 in our hospital were selected as research objects.According to random number table,those patients were divided into the group A(n=48)and the group B(n=48).During the operation,group A was given 1~2%sevoflurane to maintain anesthesia,group B was given 1~1.5%isoflurane to maintain anesthesia.The condition of perioperative period,the changes of serum E-selectin,sIL-2R,beta-EP and HMGB1 levels at T 0(before operation),T 1(operation;start 1h),T 2(the end of the operation)and T 3(after the operation 1h),the incidence of postoperative restlessness and adverse reactions were compared between two groups.Results:There was no significant difference in the intraoperative blood loss,intraoperative infusion volume and operation time between the two groups(P>0.05),the recovery time,extubation time,spontaneous breathing recovery time and length of stay of group A were significantly shorter than those of group B(P<0.05);the levels of serum E-selectin,sIL-2R,β-EP and HMGB1 in both groups at T 1,T 2 and T 3 points were significantly higher than those at T 0(P<0.05);the serum levels of E-selectin,sIL-2R,β-EP and HMGB1 of group A were significantly lower than those of group B at T 1,T 2 and T 3 points(P<0.05);the incidence of postoperative restlessness in group A was significantly lower than those in group B(P<0.05);the incidence of postoperative adverse reactions in group A was significantly lower than that in group B(P<0.05).Conclusion:Sevofluran is well for patients with radical procedure for lung cancer,which can decrease the levels of serum E-selectin,sIL-2R,β-EP and HMGB1,reduce the postoperative restlessness and adverse reaction,and promote postoperative recovery.