腹腔镜卵巢癌根治术使用经皮穴位电刺激联合丙泊酚静脉麻醉效果分析

Effects of percutaneous acupoint electrical stimulation combined with propofol intravenous anesthesia after ovarian cancer surgery

目的探讨使用经皮穴位电刺激联合丙泊酚静脉麻醉对腹腔镜卵巢癌根治术患者血清中的胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、S100钙结合蛋白(S100 calcium-binding protein,S100β)水平、氧化应激及免疫功能的影响。方法2022年1月至2022年12月河北省邯郸中心医院招募了90例接受腹腔镜手术的卵巢癌患者。研究采用随机数字表法将他们分成了对照组和观察组,每组45例患者。对照组患者给予丙泊酚静脉输注维持麻醉,观察组患者行静脉麻醉诱导前20 min采用穴位电刺激。术后评价麻醉效果,并分别于术前1 d、术后1、3 d采集所有患者的空腹静脉血,检测GFAP、S100β蛋白、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(super oxide dismutase,SOD)水平及CD3+、CD4+及CD4+/CD8+水平。结果观察组麻醉总有效率显著高于对照组(P<0.05)。术前两组血清GFAP、S100β蛋白、MDA、SOD、CD3+、CD4+、CD8+及CD4+/CD8+水平比较差异均无统计学意义(P>0.05),术后1、3 d观察组血清GFAP、S100β蛋白、MDA水平显著低于对照组(P<0.05),SOD水平显著高于对照组(P<0.05)。相较于术前,术后1 d观察组和对照组的血清GFAP、S100β蛋白、CD8+水平均显著升高,CD3+、CD4+及CD4+/CD8+水平均显著降低(P<0.05)。相较于术后1 d,术后3 d观察组和对照组的SOD、CD3+、CD4+及CD4+/CD8+水平均显著升高,血清GFAP、S100β蛋白、MDA、CD8+水平均显著降低(P<0.05)。结论相较于单独应用丙泊酚静脉麻醉,联合经皮穴位电刺激对卵巢癌根治术的麻醉效果更佳,对患者围手术期血清GFAP、S100β蛋白水平、氧化应激反应及免疫功能抑制的影响更小。

Objective To investigate the effects of percutaneous acupoint electrical stimulation combined with propofol intravenous anesthesia on serum glial fibrillary acidic protein(GFAP),S100 calcium-binding protein(S100 calciumbinding protein)levels,oxidative stress and immune function.Methods A total of 90 patients who underwent laparoscopic radical resection of ovarian cancer in our hospital were selected as research objects,and were divided into control group and observation group with 45 cases in each group according to random number table method.The control group was given intravenous infusion of propofol to maintain anesthesia,and the observation group was given acupoint electrical stimulation 20 minutes before induction of intravenous anesthesia.The effect of anesthesia was evaluated after surgery.Fasting venous blood was collected from all patients 1 day before surgery,1 day after surgery,and 3 days after surgery to detect GFAP,S100βprotein,malondialdehyde(MDA),and super oxide dismutase(SOD)levels and CD3+,CD4+and CD4+/CD8+levels.Results In observation group,the total effective rate of anesthesia was statistically higher than that in control group(P<0.05).No significant differences were found in serum levels of GFAP,S100βprotein,MDA,SOD,CD3+,CD4+,CD8+and CD4+/CD8+between the two groups before surgery(P>0.05).In the observation group,serum levels of GFAP,S100βprotein and MDA were statistically lower than those in the control group 1 day and 3 day after surgery(P<0.05).The level of SOD exhibited a significant increase compared to the control group(P<0.05).Both in observation group and control group,compared with before surgery,the levels of serum GFAP,S100βprotein and CD8+were statistically increased,while the levels of CD3+,CD4+and CD4+/CD8+were significantly decreased one day after surgery(P<0.05).Compared with 1 day after surgery,SOD,CD3+,CD4+and CD4+/CD8+levels in observation group and control group were significantly increased,while serum GFAP,S100βprotein,MDA and CD8+levels were significantly decreased(P<0.05).Conclusion Compared with intravenous anesthesia with propofol alone,combined with percutaneous acupoint electrical stimulation has better anesthetic effect on radical operation of ovarian cancer,and has less effect on serum GFAP,S100βprotein levels,oxidative stress response and immune suppression in perioperative period.