硬膜外阻滞复合全麻对结直肠癌患者激素水平及肺部感染的影响

Effects of epidural block combined with general anesthesia on hormone levels and pulmonary infection in patients with colorectal cancer

目的 探讨硬膜外阻滞复合全麻对结直肠癌患者激素水平及肺部感染的影响。方法 选取2018年8月至2020年8月间上海市青浦区朱家角人民医院收治的行手术治疗的116例结直肠癌患者,采用随机数表法分为试验组和对照组,每组58例。试验组患者使用硬膜外阻滞复合全麻,对照组患者使用全身麻醉,比较两组患者麻醉前、麻醉后30min和术后2h的皮质醇、去甲肾上腺素(NE)和肾上腺素(E)水平,并分析不同麻醉方式对术后患者肺部感染的影响。结果 麻醉前,两组患者皮质醇、E和NE水平比较,差异均无统计学意义(P>0.05);麻醉后30min和术后2h,试验组患者皮质醇、E和NE水平均低于对照组,差异均有统计学意义(均P<0.05)。两组患者术后1、2、3、5d的肺部感染情况逐渐增加,试验组患者术后5d肺部感染率低于对照组,差异有统计学意义(P<0.05)。试验组患者术后肺部感染指标情况均低于对照组,但两组比较,差异无统计学意义(P>0.05)。结论 硬膜外阻滞复合全麻可有效减少结直肠癌切除术患者术中和术后早期的应激反应,降低术后肺部感染发生率。

Objective To investigate the effects of epidural block combined with general anesthesia on hormone levels and pulmonary infection in patients with colorectal cancer. Methods A total of 116 patients who underwent colorectal cancer surgery were selected at Zhujiajiao People’s Hospital from August 2018 to August 2020. They were randomly divided into an experimental group and a control group with 58 patients in each group. The experimental group received epidural block combined with general anesthesia, and the control group received general anesthesia. Cortisol, norepinephrine(NE) and adrenalin(E) levels were compared between the two groups before anesthesia and at 30 min and 2 h after surgery. The effects of different anesthesia methods on postoperative pulmonary infection were analyzed. Results There was no significant difference in cortisol, NE and E levels between the two groups before anesthesia(P>0.05). At 30 min and 2 h after surgery, cortisol, NE and E levels were lower in the experimental group than in the control group(all P<0.05). At the same time, the incidence of pulmonary infection gradually increased on day 1, 2, 3, and 5 after the operation, and pulmonary infection indexes were lower in the experimental group than in the control group. However, there was no significant difference between the two groups(P>0.05). Conclusion Epidural block combined with general anesthesia can effectively reduce the early stress response during and after resection for colorectal cancer and the incidence of postoperative pulmonary infection.