瑞芬太尼复合麻醉对开腹结肠癌手术术后患者IL-6 MDA及SOD水平影响

doi:10.3969/j.issn.1006-6233.2018.01.005

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摘要 目的: 探究瑞芬太尼复合麻醉应用于开腹结肠癌手术对患者术后白细胞介素-6(IL-6)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平的影响。方法: 选取2015年3月至2017年3月本院收治的68例行开腹结肠癌手术患者为研究对象。按随机数表法分患者为两组,研究组(n=34)行瑞芬太尼+丙泊酚复合麻醉,对照组(n=34)行舒芬太尼+丙泊酚麻醉。观察比较两组麻醉诱导前、术后1h、术后1d、术后3d的IL-6、IL-8、CRP、MDA、SOD水平以及麻醉恢复期间不良反应率。结果: 麻醉诱导前两组IL-6、IL-8、CRP、MDA、SOD水平差异无统计学意义(P>0.05);术后两组IL-6、IL-8、CRP水平均较术前显著升高(P<0.05);组间比较,研究组术后1h、术后1d、术后3d的IL-6、IL-8、CRP水平较对照组显著更低(P<0.05)。两组MDA均升高,SOD均降低(P<0.05);组间比较,术后1h、术后1d组间对比差异不具统计学意义(P>0.05),术后3d的MDA水平较对照组低,而SOD水平较对照组高(P<0.05)。两组不良反应率差异无统计学意义(χ²=0.327,P>0.05)。结论: 瑞芬太尼复合麻醉应用于开腹结肠癌手术可显著降低IL-6、IL-8、CRP、MDA水平,提高SOD水平,对术后炎性反应、氧化应激反应的减轻作用明显。

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关键词 ：结肠癌, 瑞芬太尼, 复合麻醉, 白细胞介素-6, 氧化应激

Abstract：Objective: To investigate the effect of remifentanil combined anesthesia on the levels of interleukin-6 (IL-6), malondialdehyde (MDA) and superoxide dismutase (SOD) in postoperative patients undergoing open colon cancer surgery. Methods: From March 2015 to March 2017 in our hospital, 68 cases of open colorectal cancer patients with operation were selected as the research object. According to the random number table method the patients were divided into two groups. The study group underwent remifentanil and propofol anesthesia, the control group underwent sufentanil and propofol anesthesia. The levels of IL-6, IL-8, CRP, MDA, SOD and adverse reaction rates of the two groups before and after anesthesia induction, 1h after operation, 1D after operation and 3D after operation were compared. Results: There was no significant difference in the levels of IL-6, IL-8, CRP, MDA and SOD in the two groups before induction (P>0.05). After operation, the levels of IL-6, IL-8 and CRP in the two groups were significantly higher than those before the operation (P<0.05). One hour, oneday and three days after operation, The levels of IL-6, IL-8 and CRP in the study group were significantly lower than those in control group (P<0.05). MDA was increased and SOD decreased in both group (P<0.05). Compared between groups, there was no statistical difference in postoperative of one hour and one day (P>0.05). The MDA level of 3D after operation was lower than that of control group, while SOD level was higher than that of control group (P<0.05). There was no significant difference in the rate of adverse reaction between the two groups (χ²=0.327, P>0.05). Conclusion: Remifentanil combined anesthesia applied to open colon cancer surgery can significantly reduce the levels of IL-6, IL-8, CRP, MDA, and increase the level of SOD, which significantly reduce the postoperative inflammatory and oxidative stress response.

Key words： Colon cancer Remifentanil Combined anesthesia Interleukin -6 Oxidative stress

基金资助:湖北省自然科学基金资助项目,(编号:2013CFB465)

通讯作者: 姚帆

引用本文:

计鹏, 姚帆, 曹波, 李明强, 吴树宁, 周立文, 李才顺. 瑞芬太尼复合麻醉对开腹结肠癌手术术后患者IL-6 MDA及SOD水平影响[J]. 河北医学, 2018, 24(1): 20-26.
JI Peng, YAO Fan, CAO Bo, et al. Effects of Remifentanil Combined Anesthesia on IL-6 MDA and SOD Levels in Patients with Open Colon Cancer Surgery. HeBei Med, 2018, 24(1): 20-26.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.01.005 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I1/20

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