七氟烷复合氧化亚氮吸入麻醉对直肠癌根治术老年患者循环功能及相关蛋白表达的影响研究

Study on effects of sevoflurane combined with nitrous oxide inhalation anesthesia on circulatory function and related protein expression in elderly patients undergoing radical rectal cancer surgery

目的研究七氟烷复合氧化亚氮吸入麻醉对直肠癌根治术老年患者循环功能、S100β蛋白水平、血管紧张素Ⅱ表达水平的影响。方法选取2018年5月至2019年10月直肠癌根治术老年患者60例作为研究对象,将其分为观察组和对照组,每组30例。观察组行七氟烷复合氧化亚氮气管插管麻醉,对照组行丙泊酚和瑞芬太尼静脉注射麻醉。比较2组患者不同时间点心率、平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)及血清S100β蛋白、血管紧张素Ⅱ水平。结果与麻醉前比较,观察组患者气管插管、手术开始后10 min、导管拔管时的心率、MAP、SBP、DBP变化差异均无统计学意义(P>0.05),而对照组上述指标均明显升高,且均高于观察组,差异均有统计学意义(P<0.05)。与麻醉前比较,对照组及观察组术中2 h血清S100β蛋白水平均明显升高,且观察组明显低于对照组,差异均有统计学意义(P<0.05);术后24、72 h,对照组及观察组血清S100β蛋白水平急剧下降,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。与术前比较,对照组及观察组术后24 h血清血管紧张素Ⅱ水平均显著升高,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。结论七氟烷复合氧化亚氮吸入麻醉可有效改善直肠癌根治术老年患者循环功能,调节血清S100β蛋白水平和降低血管紧张素Ⅱ表达水平。

Objective To study the effect of sevoflurane combined with nitrous oxide inhalation anesthesia on circulatory function,S100βprotein level and angiotensinⅡexpression level in elderly patients undergoing radical rectal cancer surgery.Methods From May 2018 to October 2019,60 elderly patients undergoing radical resection of rectal cancer were selected as the research objects,and they were divided into observation group and control group,with 30 cases in each group.The observation group was anesthetized with sevoflurane combined with nitrous oxide tube intubation,and the control group was anesthetized with propofol and remifentanil intravenously.The snack rate,mean arterial pressure(MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP),and serum S100βprotein and angiotensinⅡlevels were compared between the two groups of patients at different times.Results Compared with before anesthesia,the observation group had no significant difference in the changes of heart rate,MAP,SBP,and DBP after tracheal intubation,10 minutes after the start of the operation,and catheter extubation(P>0.05).The above indicators in the control group were significantly increased,and they were all higher than the observation group,the difference was statistically significant(P<0.05).Compared with before anesthesia,the level of serum S100βprotein in the control group and the observation group was significantly increased at 2 h during the operation,and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).At 24 and 72 h after operation,the serum S100βprotein levels of the control group and the observation group dropped sharply,and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).Compared with preoperatively,the serum angiotensinⅡlevels in the control group and the observation group increased significantly after 24 hours,and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion Sevoflurane combined with nitrous oxide inhalation anesthesia can effectively improve the circulatory function of elderly patients undergoing radical rectal cancer surgery,regulate the level of serum S100βprotein and reduce the expression of angiotensinⅡ.