连续硬膜外阻滞麻醉联合静吸复合全身麻醉对子宫内膜癌患者的预后生存影响

Effect of Continuous Epidural Anesthesia combined with Intravenous Inhalation combined with General Anesthesia on Prognosis of Patients with Endometrial Cancer

目的探讨连续硬膜外阻滞麻醉联合静吸复合全身麻醉对子宫内膜癌患者预后生存的影响。方法选择接受手术治疗的63例子宫内膜癌患者为研究对象,按照其自愿选择的手术麻醉方式将其分为连续硬膜外阻滞麻醉+静吸麻醉组(A组,32例)及全身麻醉+静吸组(B组,31例),分析对比两组患者术后1个月子宫内膜组织中Leptin及VEGF蛋白表达情况,术后对两组患者开展为期3年的随访,了解不同麻醉方式对子宫内膜癌患者预后生存的影响。结果经随访分析发现,术后1年、2年及3年,A组患者生存率均优于B组患者,且A组患者预后生存方式均优于B组;术后1个月A组患者Leptin及VEGF表达阳性率均低于B组,但是对比无统计学意义(P>0.05);Cox影响因素分析发现,组织学分级、是否出现淋巴结转移、病理分级会对子宫内膜癌患者预后生存产生影响。结论采取连续硬膜外阻滞联合静吸麻醉的子宫内膜癌患者预后要优于全身麻醉联合静吸麻醉患者,连续硬膜外阻滞联合静吸麻醉的子宫内膜癌患者术后生存时间更长、转移出现时间更晚,同时分析显示组织学分级、病理分级会对子宫内膜癌患者预后生存产生影响。

Objective To investigate the effect of continuous epidural anesthesia combined with intravenous inhalation combined with general anesthesia on the prognosis of patients with endometrial cancer.Methods 63 patients with endometrial cancer who underwent surgery were enrolled in the study.They were divided into continuous epidural anesthesia+static inhalation according to their voluntary surgical anesthesia.Anesthesia group(group A,32 cases)and general anesthesia+inspiratory group(group B,31 cases),analysis and comparison of the expression of Leptin and VEGF protein in endometrial tissue of the 2 groups after operation,the patients underwent 3-year follow-up to understand the effects of different anesthesia methods on the prognosis of patients with endometrial cancer.Results After follow-up analysis,the survival rate of the group A was better than that of the group B at 1 year,2 years and 3 years after operation,and the prognosis survival of the group A was better than that of the group B.The positive rate of Leptin and VEGF expression in the group A was lower than that of the group B at 1 month after operation,but the comparison was not statistically significant(P<0.05).The analysis of factors affecting Cox found that histological grade,lymph node metastasis,and pathological grading had an impact on the prognosis of patients with endometrial cancer.Conclusion The prognosis of endometrial cancer patients with continuous epidural block combined with intravenous anesthesia is better than that of patients with general anesthesia combined with intravenous anesthesia.Endometrial cancer patients with continuous epidural block combined with intravenous anesthesia.The longer the time,the later the metastasis appeared,and the analysis showed that histological grade,lymph node metastasis,and pathological grade had an impact on the prognosis of patients with endometrial cancer.