经皮穴位电刺激联合全身麻醉对腹腔镜结直肠癌根治术患者炎性因子、T细胞亚群和认知功能的影响

Effects of Transcutaneous Acupoint Electrical Stimulation Combined with General Anesthesia on Inflammatory Factors,T Cell Subsets and Cognitive Function in Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer

目的:探讨经皮穴位电刺激(TEAS)联合全身麻醉对腹腔镜结直肠癌根治术患者炎性因子、T细胞亚群和认知功能的影响。方法:选取2018年6月~2019年9月期间我院收治的行腹腔镜结直肠癌根治术患者90例,根据随机数字表法分为对照组(n=45)和研究组(n=45),对照组给予全身麻醉处理,研究组在对照组的基础上联合TEAS,比较两组患者炎性因子、T细胞亚群、认知功能及疼痛情况。结果:研究组术后1 d、术后5 d白介素-6(IL-6)、白介素-1(IL-1)和肿瘤坏死因子-α(TNF-α)低于对照组(P<0.05)。研究组术后1 d、术后5 d CD3+、CD4+/CD8+、CD4+高于对照组,CD8+则低于对照组(P<0.05)。研究组术后1 d、术后3 d、术后5 d、术后7 d简易智力状态检查表(MMSE)评分高于对照组(P<0.05)。研究组术后6 h、术后12 h、术后24 h、术后48 h视觉模拟评分法(VAS)评分低于对照组(P<0.05)。两组术后5 d、术后7 d认知功能障碍(POCD)发生率比较差异无统计学意义(P>0.05);研究组术后1 d、术后3dPOCD发生率低于对照组(P<0.05)。结论:TEAS联合全身麻醉治疗腹腔镜结直肠癌根治术患者,可降低炎性反应,减轻免疫抑制,同时还可降低对机体认知功能的损害。

Objective: To investigate the effect of transcutaneous acupoint electrical stimulation(TEAS) combined with general anesthesia on inflammatory factors, T cell subsets and cognitive function in patients undergoing laparoscopic radical resection of colorectal cancer. Methods: 90 patients who underwent laparoscopic colorectal cancer radical surgery in our hospital were selected from June 2018 to September 2019, they were divided into control group(n=45) and study group(n=45) according to the random number table method. The control group was given general anesthesia. The study group combined with TEAS on the basis of the control group.Inflammatory factors, T cell subsets, cognitive function and pain were compared between the two groups. Results: The levels of interleukin-6(IL-6), interleukin-1(IL-1), tumor necrosis factor-α(TNF-α) in the study group at 1 d after operation, 5 d after operation were lower than those in the control group(P<0.05). CD3^+, CD4^+/CD8^+ and CD4^+in the study group were higher than those in the control group at 1 d after operation, 5 d after operation, while CD8^+ was lower than that in the control group(P<0.05). The scores of simple mental state Checklist(MMSE) in the study group were higher than those in the control group at 1 d after operation, 3 d after operation, 4 d after operation, 7 d after operation(P<0.05). The visual analogue scale(VAS) score of the study group was lower than that of the control group at 6 h after operation, 12 h after operation, 24 h after operation, 48 h after operation(P<0.05). There was no significant difference in the incidence of cognitive impairment(POCD) between the two groups on the 5 th and 7 th postoperative days(P>0.05);the incidence of POCD in the study group at 5 d after operation, 7 d after operation was lower than that in the control group(P<0.05). Conclusion: TEAS combined with general anesthesia can reduce inflammatory response, immune suppression and cognitive impairment in patients undergoing laparoscopic colorectal cancer radical resection.