【摘要】 目的 探讨全身麻醉联合硬膜外阻滞麻醉对宫颈癌手术患者应激反应及辅助性T细胞（Th）偏移的影响。方法 选取2016年1月至2018年12月江苏省泰州市人民医院收治的106例宫颈癌患者作为研究对象。随机分为观察组和对照组，各53例。观察组采用全身麻醉联合硬膜外阻滞麻醉，对照组采用单纯全身麻醉。记录两组失血量，采用视觉模拟评分法（VAS）评分评估镇痛效果，采用放射免疫法测定生长激素（GH）、催乳素（PRL）及皮质醇（Cor）水平，采用流式细胞术检测Th1、Th2及调节性T细胞（Treg）比例并计算Th1/Th2比值。结果 观察组失血量、VAS评分均低于对照组，差异具有统计学意义（P<0.05）；观察组GH、PRL及Cor、Th2、Treg细胞比例在麻醉维持期及术后各时点均低于对照组，差异具有统计学意义（P<0.05）；观察组Th1细胞比例、Th1/Th2比值在麻醉维持期及术后各时点均高于对照组，差异具有统计学意义（P<0.05）。结论 全身麻醉联合硬膜外阻滞麻醉能够更好地缓解宫颈癌手术患者应激反应，并可保护其免疫功能。更多还原

【Abstract】 Objective To discuss the effect of general anesthesia combined with epidural block on postoperative stress response and helper T cell(Th) shift in cervical cancer.Methods 106 patients with cervical cancer admitted to Jiangsu Taizhou People′s Hospital from January 2016 to December 2018 were selected and randomly divided into observation group and control group, 53 cases in each group. The observation group received general anesthesia combined with epidural block anesthesia, and the control group received general anesthesia alone. The blood loss of the two groups was recorded, and the analgesic effect was evaluated by visual analogue scale(VAS). The levels of growth hormone(GH), prolactin(PRL) and cortisol(Cor) were determined by radioimmunoassay. The ratio of Th1, Th2 and regulatory T cells(Treg) was determined by flow cytometry and the Th1/Th2 ratio was calculated.Results Blood loss and VAS score in the observation group were lower than those in the control group(P< 0. 05). GH, PRL, and the proportion of Cor, Th2 and Treg cells in the observation group was lower than that in the control group at each time point during the anesthesia maintenance period and after surgery(P< 0. 05). The proportion of Th1 cells and Th1/Th2 ratio in the observation group were higher than those in the control group at each time point during the maintenance period and after anesthesia(P< 0. 05).Conclusions General anesthesia combined with epidural block anesthesia can better alleviate stress response and protect immune function in patients with cervical cancer after surgery.更多还原