摘要
目的:研究全身麻醉复合硬膜外麻醉对胃癌根治术患者术后感染及TLR4/NF-κB信号通路的影响。方法:选取本院2019年1月-2020年1月收治的胃癌患者120例为研究对象。采用抽签方式将患者分为研究组与对照组,每组60例。两组均采用胃癌根治术进行切除治疗,其中研究组利用全身麻醉复合硬膜外麻醉进行麻醉,对照组采用单纯全身麻醉。比较两组患者免疫功能、应激反应水平、感染发生情况、TLR4、NF-κB表达水平。结果:干预前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Cor、IL-6、TNF-α、Glu、TLR4、NF-κB比较,差异均无统计学意义(P>0.05);干预后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较干预前降低,但研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均显著高于对照组,差异均有统计学意义(P<0.05)。干预后,研究组Cor、IL-6、TNF-α、GLU均显著低于对照组,差异均有统计学意义(P<0.05)。干预后,研究组感染发生率显著低于对照组,差异有统计学意义(P<0.05)。干预后,研究组TLR4、NF-κB均低于对照组(P<0.05)。对照组干预前后TLR4比较,差异有统计学意义(P<0.05)。结论:全身麻醉复合硬膜外麻醉与单纯全麻相比,能有效减少患者应激反应与感染,改善患者免疫功能、TLR4、NF-κB信号通路,值得临床推广。
Objective:To investigate the effect of general anesthesia combined with epidural anesthesia on postoperative infection and TLR4/NF-κB signaling pathway in patients undergoing radical gastrectomy.Method:A total of 120 patients with gastric cancer admitted to our hospital from January 2019 to January 2020 were selected as the research objects.The patients were divided into study group and control group by lotting,60 cases in each group.Both groups were treated with radical gastrectomy,in which the study group was treated with general anesthesia combined with epidural anesthesia,while the control group was treated with general anesthesia alone.The immune function,stress response level,infection incidence,TLR4,NF-κB expression levels were compared between two groups.Result:Before intervention,there were no significant differences in CD3^(+),CD4^(+),CD4^(+)/CD8^(+),Cor,IL-6,TNF-α,Glu,TLR4 and NF-κB between the two groups(P>0.05).After intervention,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were decreased compared with before intervention,while CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the research group were significantly higher than those in the control group,with statistical significance(P<0.05).After intervention,Cor,IL-6,TNF-αand Glu in the study group were significantly lower than those in the control group,with statistical significance(P<0.05).After intervention,the incidence of infection in the study group was significantly lower than that in the control group,with statistical significance(P<0.05).After intervention,TLR4 and NF-κB in the study group were lower than those in the control group(P<0.05).Comparison of TLR4 before and after intervention in the control group,the differences was statistically significant(P<0.05).Conclusion:Compared with simple general anesthesia,general anesthesia combined with epidural anesthesia can effectively reduce the stress response and infection of patients,improve the immune function,TLR4,NF-κB signaling pathway in patients,which is worthy of clinical promotion.
作者
谢丹
毕聪杰
于东海
赵慧
XIE Dan;BI Congjie;YU Donghai;ZHAO Hui(Dalian Central Hospital Affiliated to Dalian Medical University,Dalian 116033,China;不详)
出处
《中国医学创新》
CAS
2021年第3期43-47,共5页
Medical Innovation of China
关键词
全身麻醉复合硬膜外麻醉
胃癌
围手术期
General anesthesia combined with epidural anesthesia
Gastric cancer
Perioperative period
