摘要
目的探讨乌司他丁对腹腔镜直肠癌手术围术期炎性反应的影响。方法择期全麻下行腹腔镜直肠癌根治术(骶前吻合)患者60例,年龄40～60岁,体重50～70kg。患者随机分为两组,每组30例。乌司他丁组(U组)将乌司他丁2.5kU/kg用生理盐水50ml稀释,入室后缓慢静注(10min),另2.5kU/kg加入250ml生理盐水中滴注(从入室开始1h滴完)。对照组(C组)用等量生理盐水以同样方法输注。采用放射免疫法测定静脉血IL-6、IL-8和TNF-α浓度;用ELISA法测定血清中C反应蛋白(CRP)浓度;用ELISA试剂盒测定血清肠型脂肪酸结合蛋白(I-FABP)浓度。结果与气腹前比较,气腹消除后10min、6h及术后24、48h两组患者IL-6、IL-8、TNF-α、CRP浓度明显升高(P<0.05或P<0.01),且C组明显高于U组(P<0.05);两组I-FABP浓度在气腹消除后10min和6h均明显升高(P<0.05或P<0.01),且C组明显高于U组(P<0.05),C组在术后24h仍明显高于U组(P<0.05)。结论乌司他丁用于腹腔镜直肠癌手术可以减轻气腹期间促炎性细胞因子的生成和释放,对肠黏膜有一定的保护作用。
Objective To investigate the effects of ulinastatin on inflammatory reaction during the perioperative pneumoperitoneum recthl cancer operation. Methods Sixty cases of laparoscopic rectal cancer surgery under general anesthesia patients, aged 40-60 years old, weighing 50-70 kg, were equally randomized into two groups： ulinastatin group （group U） and control group （group C）. Ulinastatin 2.5 kU/kg diluted into 50 ml saline was given by slowly intravenous injection（about 10 rain）and ulinastatin 2.5 kU/kg in 250 ml saline was intravenous infused within 1 h in group U, while group C received the same amount of saline. The serum concentrations of IL-6, IL-8, TNF-α, C response protein （CRP）, and intestinal type fatty acid-binding Protein （I-FABP） at 10 min before pneumoperitoneum （To）, 10 min after pneumoperitoneum （T1）, 6 h after pneumoperitoneum （T2）, 24 h after surgery （T3）, and 48 h after surgery （T4） were measured. Results Compared with To, IL-6, IL-8, TNF-α, CRP concentrations increased at T1 , T2, T3, and T4 in the two groups with higher concentrations in group C than in group U （P〈0.05）. I-FABP concentration increased at T1 and T2 in both groups with higher concentrations in group C than in group U （P ~ 0.05 ）. Conclusion Ulinastatin may decrease the perioperative concentrations of blood proinflammatory cytokines in patients undergoing pneumoperitoneum rectal cancer operation.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第8期756-758,共3页
Journal of Clinical Anesthesiology
