硬膜外阻滞联合全麻对腹腔镜结肠癌根治术患者细胞因子水平及认知功能的影响

杨建勇，荆宁宁

（平原县第一人民医院麻醉科，山东 德州，253100）

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摘要：

目的 探究硬膜外阻滞联合全麻对腹腔镜结肠癌根治术患者的细胞因子水平及认知功能的影响。方法 选择我院接诊的110例拟行腹腔镜结肠癌根治术患者，随机分为对照组和观察组，各55例。对照组采用全麻，观察组采用硬膜外阻滞联合全麻。比较手术后两组患者的细胞因子水平及认知功能。结果 手术后，两组患者的S-100β、IL-6 及TNF-α水平均较治疗前升高，但观察组均低于对照组（P<0.05）。术后1 h，两组患者认知功能评分均手术前降低，且观察组高于对照组（P<0.05）；术 后1 d，两组患者的认知功能评分较术后1 h 有所升高，且观察组的认知功能评分高于对照组（P<0.05），但观察组与手术前比较，无显著差异（P>0.05），对照组的认知功能评分仍低于手术前（P<0.05）。结论 对行腹腔镜结肠癌根治术患者采用硬膜外阻滞联合全麻可以有效改善患者的炎症细胞因子水平，对患者的认知功能影响较小。

关键词：硬膜外阻滞；全麻；腹腔镜结肠癌根治术

中图分类号：R614文献标志码：A文章编号：2096-1413(2017)21-0052-02

Effects of epidural anesthesia combined with general anesthesia on cytokine levels and cognitive function in patients undergoing laparoscopic
radical surgery of colon cancer
YANG Jian-yong, JING Ning-ning
(Department of Anesthesia, the First People``s Hospital of Pingyuan County, Dezhou 253100, China)

ABSTRACT: Objective To investigate the effects of epidural anesthesia combined with general anesthesia on cytokine levels and cognitive function in patients undergoing laparoscopic radical surgery of colon cancer. Methods A total of 110 cases of patients with laparoscopic radical surgery of colon cancer in our hospital were randomly divided into control group and observation group, with 55 cases in each group. The control group used general anesthesia, while the observation group received epidural anesthesia combined with general anesthesia. The cytokine levels and cognitive function after surgery of the two groups were compared. Results After operation, the S-100β, IL-6, TNF-α levels in the two groups increased, but those in the observation group were lower than the control group (P<0.05). One hour after operation, the cognitive function scores of the two groups decreased, and that in the observation group was higher than the control group (P<0.05). One day after operation, the cognitive function scores of the two groups were higher than those 1 h after operation, and those in the observation group was higher than the control group (P<0.05), but there was no significant difference in the cognitive function scores between 1 d after operation and before operation in the observation group (P>0.05), and the cognitive function scores of 1 d after operation in the control group was still lower than that before operation (P<0.05). Conclusion Using epidural anesthesia combined with general anesthesia in patients undergoing laparoscopic radical surgery of colon cancer can effectively improve inflammatory cytokine levels and has less effect on cognitive function.
KEYWORDS: epidural anesthesia; general anesthesia; laparoscopic radical surgery of colon cancer

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