摘要
目的评估不同麻醉及镇痛方法对直肠癌根治术患者血清血管内皮生长因子C(VEGF-C)和前列腺素E2(PGE2)的影响。方法将60例拟行直肠癌根治术的患者随机分为3组:A组行全身麻醉联合硬膜外麻醉和硬膜外镇痛,B组行全身麻醉联合硬膜外镇痛,C组行全身麻醉联合患者自控静脉镇痛;应用视觉模拟评分表测定患者的静态痛觉评分,采用酶联免疫吸附试验测定麻醉诱导前及术后48h时血清VEGF-C和PGE2水平,对比分析3组患者静态痛觉评分、血清VEGF-C和PGE2水平。结果所有患者均顺利完成手术,镇痛效果良好。3组患者术后静态痛觉评分差异无统计学意义(P>0.05),患者术前VEGF-C和PGE2水平差异无统计学意义(P>0.05)。A组患者术后血清VEGF-C水平明显低于术前,差异有统计学意义(t=0.415,P<0.05);3组患者术后VEGF-C血清水平组间比较差异有统计学意义(P<0.05)。A组患者术后血清PGE2水平与术前比较差异有统计学意义(t=0.601,P<0.05);3组患者术后PGE2水平组间比较差异均无统计学意义(P>0.05)。结论全身麻醉联合硬膜外麻醉和镇痛能更有效降低直肠癌根治术患者血清VEGF-C水平,有可能利于降低肿瘤复发率,值得进一步研究。
Objective To explore the different anesthesia and analgesia effects for serum vascular endothelial growth factor C（VEGF-C）and prostaglandin E2（PGE2）in radical resection of rectal carcinoma.Methods Totally 60 cases of rectal carcinoma patients were randomly divided into three groups,the group A：general anesthesia combined with intraoperative epidural anesthesia,postoperation epidural anesthesia;the group B：general anesthesia combined with postoperation epidural anesthesia;the group C：general anesthesia combined with patient-controlled intravenous analgesia.The static pain score were evaluated by visual analogue scale;the VEGF-C and PGE2 were measured by enzyme linked immunosorbent assay in anesthesia induction and 48 hafter surgery.All the three group patients′data were compared.Results All patients were successfully completed surgery;analgesic effect was satisfied.There were no statistically significant in static pain score among three groups（P〉0.05）.Before the surgery,there were no statistically significant in VEGF-C and PGE2 among three groups（P〉0.05）.After the surgery,the level of serum VEGF-C in group A was significantly lower than that before operation（t=0.415,P〈0.05）,there were statistically significant in VEGF-C among three groups（P〈0.05）.After the surgery,there were statistically significant in PGE2 before and after operation in group A（t=0.601,P〈0.05）,there were not statistically significant in PGE2 among three groups（P〉0.05）.Conclusion The general anesthesia combined with intraoperative epidural anesthesia,postoperation epidural anesthesia can more effective reduce the VEGF-C serum concentration in radical resection of rectal carcinoma,which is possible to reduce tumor recurrence.
作者
朱元茂
饶传华
李军
童珊珊
ZHU Yuanmao RAO Chuanhua LI dun TONG Shanshan(Department of Anesthesiology, Central Hospital of Jiangjin District, Chongqing 402260, Chin)
出处
《检验医学与临床》
CAS
2017年第16期2400-2402,共3页
Laboratory Medicine and Clinic
关键词
硬膜外麻醉
全身麻醉
直肠肿瘤
血管内皮生长因子C
前列腺素E类
epidural anesthesia
general anesthesia
rectal carcinoma
vascular endothelial growth factor C
prostaglan din E
