目的：探讨丙泊酚与异氟醚麻醉对老年结肠癌手术患者血浆炎性因子及术后躁动的影响。方法选择2012年1月至2014年3月本院普外科收治的原发性结肠癌患者90例，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级，采用随机数表法将入选患者随机分为A、B两组，每组各45例，两组患者均择期行超声引导下的经皮肝穿刺结肠癌射频消融术治疗，A组患者麻醉诱导采用3％异氟醚，B组给予丙泊酚2 mg/kg麻醉诱导，其他诱导给药两组相同，采用酶联免疫吸附测定检测患者的血清白细胞介素（IL）-10、IL-4、血管内皮生长因子（VEGF）-1及高迁移率族蛋白1（HMGB1）的浓度，并随访术后躁动情况及咽喉反射恢复时间和拔管时间。结果麻醉诱导前（T0）、手术开始时（T1）、手术结束时（T2）及术后24小时（T3），两组患者IL-10、IL-4、HMGB1及VEGF-1浓度组内比较差异具有显著性（P＜0.05），且T0＜T1＜T2＜T3，T3时间点达到峰值。在T2和T3时间点，B组患者IL-l0、IL-4水平显著高于A组，VEGF-1和HMGB1水平显著低于A组，差异具有显著性（P＜0.05)。T0、Tl时间点，两组患者IL-10、VEGF-1、IL-4以及HMGB1水平组间比较差异无显著性（P＞0.05）。根据围术期患者的恢复情况及术后24小时随访情况分析，A组患者5例（11.11%）发生术后躁动，B组16例（35.56%），两组比较差异具有显著性（P＜0.05）；两组患者咽喉反射恢复时间和拔管时间比较差异无显著性（P＞0.05）。结论丙泊酚吸入较异氟醚可更好地调节结肠癌手术患者围术期的血浆炎性因子IL-10、IL-4、VEGF-1及HMGB1的水平，提高了肿瘤患者抗炎能力，适合在临床推广应用。%Objective To explore the effect of propofol and isolfurane anesthesia on postoperative agitation and plasmatic inlfammatory factors in elderly patients treated by colon cancer surgery. Method 90 cases of patients with constitutional colon cancer treated in department of general surgery in our hospital from January 2012 to March 2014 were graded as gradeⅠ~Ⅱaccording to American Society of Anesthesiologists (ASA). They were randomly divided into group A and B, each group for 45 cases. The patients in the two groups were treated with ultrasound-guided radiofrequency ablation of colon cancer with percutaneous transhepatic. 3%isolfurane was used for anesthesia induction in group A, 2 mg/kg propofol was used for anesthesia induction in group B. The other administrations to the two groups were the same. Enzyme-linked immunosorbent assay was used for detect concentrations of serum interleukin (IL) -10, IL-4, vascular endothelial growth factor (VEGF)-1 and high mobility group protein 1 (HMGB1) in patients. The patients were followed up for observing postoperative agitation condition, recovery time of laryngopharyngeal reflux and time to extubation. Result At T0, T1, T2 and T3 time point, concentrations of IL-10, IL-4, HMGB1 and VEGF-1 had signiifcant difference when compared within group (P<0.05), moreover T00.05). By analying recovery condition of perioperative patients and 24 hours postoperative follow-up, there were 5 cases (11.11%) of postoperative agitation in group A, and 16 cases (35.56%) in group B, with signiifcant difference (P<0.05). There was no signiifcant difference in recovery time of laryngopharyngeal relfux and time to extubation in the two groups (P > 0.05). Conclusion Propofol inhalation could regulate levels of plasmatic inlfammatory factors IL-10, IL-4, VEGF-1 and HMGB1 more effectively than isolfurane. Propofol enhanced capacity of anti-inlfammation in the patients, which is suitable for clinical application.
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