【摘要】 目的:研究不同麻醉方法对结直肠肿瘤患者围手术期T淋巴细胞亚群及血糖的影响。方法:选择2016年1月-2017年12月本院收治的46例结直肠肿瘤患者,随机分为全麻组与联麻组,每组43例。全麻组采用全身麻醉,联麻组采用硬膜外麻醉联合全身麻醉。设定麻醉前(T1)、麻醉后(T2)、术后1 h(T3)、术后24 h(T4)、术后48 h(T5)5个监测时间点,测定并比较各时间点外周静脉血血糖与T淋巴细胞亚群变化。结果:两组T2血糖均明显高于T1(P<0.05)。联麻组T2血糖明显低于全麻组(P<0.05)。随着恢复时间的延长,全麻组T5、联麻组T4血糖与T1相比,差异均无统计意义(P>0.05)。与T1相比,两组T2、T3、T4 CD3~+、CD4~+、CD8~+、CD4~+/CD8~+各指标均明显降低(P<0.05)。联麻组T2～T5时间点各项指标逐渐升高,至T5基本接近正常,与全麻组相比,差异有统计意义(P<0.05)。而全麻组至T5时间点,各指标仍明显低于麻醉前(P<0.05)。结论:硬膜外联合全身麻醉能够减少腹部肿瘤患者围手术期应激反应,有利于术后血糖及免疫功能尽早恢复。更多还原

【Abstract】 Objective:To study the effect of different anesthesia techniques on the perioperative changes in T-lymphocyte subsets and blood glucose in patients with colorectal cancer.Method:From January 2016 to December2017,46 patients with colorectal cancer were selected from our hospital,they were randomly divided into general anesthesia group and combined anesthesia group,23 cases in each group.General anesthesia was used in general anesthesia group and epidural anesthesia combined with general anesthesia was used in combined anesthesia group.Five monitoring time points were set:before anesthesia(T1),after anesthesia(T2),1 h after surgery(T3),24 h after surgery(T4),and 48 h after surgery(T5).The changes of blood glucose and T-lymphocyte subgroups were measured and compared.Result:The blood glucose of two groups at T2 were significantly higher than those of at T1(P<0.05).At T2,the blood glucose levels were measured,the combined anesthesia group was significantly lower than that of the general anesthesia group(P<0.05).As the recovery time of patients was prolonged,T5 of general anesthesia group and T4 of the combined anesthesia group showed no statistically significant difference in blood glucose level compared with T1(P>0.05).Compared with T1,the indexes of CD3~+,CD4~+,CD8~+,and CD4~+/CD8~+ were significantly decreased in two groups at T2,T3 and T4(P<0.05).In the combined anesthesia group,the indicators gradually increased from T2 to T5,and T5 was almost normal,and the difference was statistically significant compared with the general anesthesia group(P<0.05).However,all the indexes of the general anesthesia group at T5 were still significantly lower than those of before anesthesia(P<0.05).Conclusion:Epidural combined with general anesthesia can reduce the perioperative stress response in patients with colorectal cancer,which is helpful for the early recovery of postoperative blood glucose and immune function.更多还原