摘要
目的研究术前乌司他丁、戊乙奎醚联合应用对腹腔镜结直肠癌手术患者免疫及肝肾功能的影响。方法选取2016年3月—2018年5月我院择期行腹腔镜手术的86例结直肠癌患者,根据不同术前用药方法均分为观察组与对照组。对照组术前30min给予戊乙奎醚,观察组在对照组基础上于麻醉诱导前给予乌司他丁。观察并记录两组用药后术中情况,术前与术后1、3d细胞免疫及肝肾功能情况,以及不良反应发生情况。结果观察组术中麻醉时间与术后排气时间明显短于对照组(P<0.01)。术后1d与术前相比,两组CD3+、CD4+、CD8+、CD4+/CD8+下降,后随住院时间的延长CD3+、CD4+、CD4+/CD8+均升高,CD8+均下降,总体比较差异有统计学意义(P<0.05或P<0.01);两组术后1dCD3+、CD4+、CD8+及术后3dCD3+、CD4+、CD8+、CD4+/CD8+比较差异均有统计学意义(P<0.05或P<0.01)。术后1d与术前相比,两组天冬氨酸转氨酶(AST)降低,丙氨酸转氨酶(ALT)、血尿素(BUN)、血肌酐(SCr)均明显升高,后AST、ALT、BUN、SCr呈下降趋势,总体比较差异有统计学意义(P<0.01);两组术后1dAST、ALT、BUN、SCr及术后3dAST、ALT、BUN比较差异均有统计学意义(P<0.01)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论与单独使用戊乙奎醚相比,术前乌司他丁联合戊乙奎醚可减少腹腔镜结直肠癌手术患者术中组织器官损伤,同时降低腹腔镜手术对患者免疫功能及肝肾功能的损害。
ObjectiveTo study the effect of preoperative ulinastatin combined with penehyclidine on immunity and liver and kidney function in patients undergoing laparoscopic colorectal surgery.MethodsEighty-six patients with colorectal cancer who underwent elective laparoscopic surgery in our hospital from March 2016 to May 2018 were selected.Patients were divided into control group and observation group according to different preoperative medications.The control group was given penehyclidine 30 min before the operation, while the observation group was supplemented with ulinastatin before the induction of anesthesia on the basis of the control group.The intraoperative condition after taking the medication, condition of cellular immunity and liver and kidney function before operation, on the first day and the third day before and after operation, and adverse reactions of the two groups were observed and recorded.ResultsThe anesthesia time during operation and exhaust time after operation were significantly shorter in the observation group than in the control group ( P <0.01).Compared with those before operation, CD 3 +, CD 4 +, CD 8 +, CD 4 +/CD 8 + were decreased on the first day after operation.In addition, CD 3 +, CD 4 +, CD 4 +/CD 8 + were increased while CD 8 + was decreased with prolongation of hospitalization( P <0.05 or P <0.01).There were significant differences in CD 3 +, CD 4 +, CD 8 + on the first day after operation, and in CD 3 +, CD 4 +, CD 8 + and CD 4 +/CD 8 + after operation ( P <0.05 or P <0.01).Compared with those before surgery, the aspartate aminotransferase (AST) was significantly decreased, whereas alanine aminotransferase (ALT), blood urea (BUN) and serum creatinine (SCr) were increased significantly on the first day after surgery.Then AST, ALT, BUN and SCr showed a downward trend ( P <0.01).In both groups, significant differences were found in AST, ALT, BUN and SCr on the first day after operation and AST, ALT and BUN on the third day after operation ( P <0.01).There was no significant difference in the total incidence of adverse reactions between the two groups ( P >0.05).ConclusionCompared with penehyclidine alone , preoperative ulinastatin combined with penehyclidine can reduce the injury of tissues and organs during laparoscopic colorectal surgery.In the meantime, it can reduce the impact of laparoscopic surgery on immunity and the damage to liver and kidney function.
作者
路敏
孙伟伟
王月新
杨静
李海燕
朱爱
王进峰
LU Min;SUN Wei-wei;WANG Yue-xin;YANG Jing;LI Hai-yan;ZHU Ai;WANG Jin-feng(Department of Anesthesiologythe People's Hospital of Cangzhou City,Cangzhou,Hebei 061000,China;Department of Operating Room,the People's Hospital of Cangzhou City,Cangzhou,Hebei 061000,China;Department of Surgery,Traditional Chinese Medicine Hospital of Shijiazhuang,Shijiazhuang 050000,China)
出处
《临床误诊误治》
2019年第10期42-46,共5页
Clinical Misdiagnosis & Mistherapy
基金
2018年度河北省医学科学研究重点课题项目(20181087)
沧州市科学技术研究与发展指导计划项目(162302079)
关键词
结直肠肿瘤
腹腔镜
乌司他丁
戊乙奎醚
免疫功能
肝肾功能
Colorectal neoplasms
Laparoscopes
Ulinastatin
Penehyclidine
Immune function
Liver and kidney function
