不同麻醉方式对胃癌根治术患者肝肾功能及氧合功能的影响

doi:10.3969/j.issn.1006-6233.2020.09.025

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摘要 目的: 分析不同麻醉方式对胃癌根治术患者肝肾功能及氧合功能的影响。方法: 选择2016年8月至2019年8月我院收治的胃癌根治术患者100例纳入本次研究,采用简单随机分组法分为观察组(n=53)和对照组(n=47)。对照组使用全身麻醉,观察组采用硬膜外阻滞复合全身麻醉。比较两组患者术后临床指标、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、尿氮素(BUN)、血肌酐(Cr)、肺内血分流率(QS/QT)、乳酸(ABL)、C反应蛋白(CRP)、白细胞介素-2(IL-2)、白细胞介素-8(IL-8)水平变化情况及不良反应发生情况。结果: 观察组呼吸恢复时间、睁眼时间、拔管时间及躁动评分均显著低于对照组,差异显著(P<0.05);术前,两组肝肾功能水平无显著差异;术后,两组肝肾功能均有所上升,两组BUN、Cr水平无显著差异,观察组术后ALT、AST、TBIL差值均显著低于对照组,差异显著(P<0.05);术前,两组氧合指标水平无明显差异;术后,两组氧合指标水平均有所升高,且观察组QS/QT、ABL水平差值均显著低于对照组(P<0.05);术前,两组应激反应水平无明显差异;术后,两组应激反应水平均有所升高,且观察组CRP、IL-2、IL-8水平差值均显著低于对照组(P<0.05);两组不良反应总发生率分别为5.66%、19.15%,差异显著(P<0.05)。结论: 在胃癌根治术患者中采用硬膜外阻滞复合全身麻醉效果显著,可有效改善患者肝功能及氧合功能水平,值得推广应用。

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关键词 ：胃癌根治术, 硬膜外阻滞, 全身麻醉, 肝肾功能, 氧合功能

Abstract：Objective: To study the curative efficacy of different anesthesia methods radical gastrectomy and the effects on liver and kidney function and oxygenation function.Methods: 100 patients admitted to our hospital for radical gastrectomy from August 2016 to August 2019 were included in this study and divided into the observation group (n=53) and the control group (n=47) with simple random grouping method.The control group received general anesthesia, and the observation group received epidural block combined with general anesthesia.The two groups were compared with postoperative clinical indicators, cereal third transaminase (ALT), aspertate aminotransferase (AST), total bilirubin (TBIL), urine nitrogen (BUN), serum creatinine (Cr), pulmonary blood FenLiuLv (QS/QT), lactic acid (ABL), c-reactive protein (CRP) and interleukin 2 (IL 2) and interleukin 8 (IL - 8) level changes and the occurrence of adverse reactions.Results: The respiratory recovery time, eye-opening time, extubation time and restlessness score of the observation group were significantly lower than those of the control group (P<0.05); before operation, there was no significant difference in the level of liver and kidney function between the two groups; after operation, the liver and kidney function of the two groups were increased, but there was no significant difference in the level of BUN and Cr between the two groups; ALT, AST and TBIL of the observation group were significantly lower than those of the control group (P<0.05) Before operation, there was no significant difference in the level of oxygenation index between the two groups; after operation, the level of oxygenation index in the two groups increased, and the QS / QT and ABL levels in the observation group were significantly lower than those in the control group (P<0.05); before operation, there was no significant difference in the level of stress reaction between the two groups; after operation, the level of stress reaction in the two groups increased on average, and the level of CRP, IL-2 and IL-8 in the observation group were significantly lower than those in the control group (P<0.05).The total incidence of adverse reactions in the two groups was 5.66% and 19.15%, respectively, with significant difference (P<0.05).Conclusion: Epidural block combined with general anesthesia in patients with radical gastrectomy has a significant effect, and can effectively improve the liver function and oxygenation function level of patients, which is worthy of promotion and application.

Key words： Radical gastrectomy Epidural block General anesthesia Liver and kidney function Oxygenation function

基金资助:广西自然科学基金项目,(编号:2014A4063)

引用本文:

赵建立, 黄红梅, 李文栋, 黄敏坚, 韦巧松. 不同麻醉方式对胃癌根治术患者肝肾功能及氧合功能的影响[J]. 河北医学, 2020, 26(9): 1514-1518.
ZHAO Jianli, HUANG Hongmei, et al. The Comparison of Curative Efficacy of Different Anesthesia Methods in Radical Gastrectomy and the Effects on Liver and Kidney Function and Oxygenation Function. HeBei Med, 2020, 26(9): 1514-1518.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.09.025 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I9/1514

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