摘要
目的探讨两种麻醉方式对腹腔镜胃癌根治术CO_2气腹对患者血气及应激水平的影响,为采用合理的麻醉方式提供理论依据。方法选取我院收治的110例胃癌行腹腔镜手术治疗患者,将其随机分为A组以及B组,每组55例,其中A组采用深麻醉方法,B组采用浅麻醉方法,比较两组患者气腹前以及气腹后的血气分析变化,比较两组患者麻醉前、术毕、术后72h的免疫指标变化情况。结果与气腹前比较,A组血气分析指标变化无明显差异,P>0.05;B组与气腹前比较,Pa CO2、BE、TCO_2明显升高,pH明显下降,P<0.05。且组间比较气腹后PaCO_2、BE、TCO_2、pH有明显差异,P<0.05。术毕相比于麻醉前,两组CD3^+、CD4^+、CD4^+/CD8^+以及NK细胞水平均明显下降,P<0.05。且组间比较有明显差异,B组更加明显,P<0.05。术后72h各项指标均恢复至麻醉前,且两组间比较无明显差异,P>0.05。结论深麻醉对机体的细胞免疫影响小,术中血气分析指标平稳,将其应用于腹腔镜胃癌手术效果优于浅麻醉。
Objective To investigate the effect of CO_2 pneumoperitoneum of laparoscopic radical gastrectomy with two anesthesia methods on the blood gas and stress level in gastric cancer patients,so as to provide theoretical basis for a reasonable anesthesia methods. Methods 110 cases of gastric cancer patients underwent laparoscopic surgery treatment were randomly divided into two groups,group A（ with deep anesthesia,55 cases） and group B（ with superficial anesthesia,55 cases）. The blood gases in patients were measured before and after pneumoperitoneum. The immune indicators changes were detected before anesthesia,after post-operation and 72 h post-operation. Results There was no significant difference on blood gas analysis indexes in Group A compared with that before the pneumoperitoneum（ P 〉0. 05）. Compared with before pneumoperitoneum,the Pa CO2,BE and T CO_2 levels in Group B were significantly elevated and p H value was significantly decreased（ P〈 0. 05）.The levels of CD3~＋,CD4~＋,CD4~＋/ CD8~＋ and NK cell in both groups after post-operation were decreased significantly compare with before anesthesia（ 〈P 0. 05）,and also had significant difference between two groups（ P 〈0. 05）. These indexes were recovered to that of before the anesthesia at 72 h after operation,and no significant difference between two groups（ P 〉0. 05）. Conclusion The deep anesthesia has little influence on the body＇s cellular immune and the blood gas analysis indexes are smooth during the operation,it might be better than that of the shallow anesthesia in laparoscopic surgery for gastric cancer patients.
出处
《标记免疫分析与临床》
CAS
2015年第11期1104-1106,共3页
Labeled Immunoassays and Clinical Medicine
关键词
麻醉
腹腔镜
胃癌
气腹
应激
Anesthesia
Laparoscopic
Gastric cancer
Pneumoperitoneum
Stress
