丙泊酚和七氟醚对行腹腔镜子宫切除术宫颈癌患者围手术期免疫反应的影响

摘要

目的 探讨丙泊酚和七氟醚对行腹腔镜子宫切除术治疗宫颈癌患者围手术期免疫反应的影响.方法将宫颈癌患者120例作为研究对象,根据随机数字表法将患者分为观察组与对照组各60例,所有患者均于腹腔镜下行保留盆腔自主神经的子宫切除手术,对照组给予基于丙泊酚的麻醉干预,观察组给予基于丙泊酚和七氟醚的麻醉干预,记录麻醉效果与围手术期免疫反应.结果 两组手术时间、术中出血量、淋巴结清扫总数对比差异无统计学意义(P>0.05),观察组的术后恢复排气时间与术后住院时间明显少于对照组(P<0.05).观察组术后盆腔器官损伤、尿失禁、尿瘘、淋巴囊肿、血栓等并发症发生率为6.7%,对照组为10.0%,组间对比差异无统计学意义(P>0.05).观察组的苏醒时间、拔管时间明显少于对照组(P<0.05),两组丙泊酚用量对比差异无统计学意义(P>0.05).观察组术后48d的CD4+CD25+T和CD4+OX40+T 分别为(5.85 ±1.33)%和(8.52 ±3.17)%,对照组为(7.14 ±1.04)%和(10.43 ± 2.85)%,组间对比差异明显(P<0.05),也都明显低于术前(P<0.05).结论 丙泊酚和七氟醚在腹腔镜子宫切除术治疗宫颈癌患者中的应用能降低围手术期免疫反应,提高麻醉效果,从而促进患者的康复.%Objective To investigate the effects of propofol and sevoflurane on perioperative immune response in pa -tients treated with laparoscopic hysterectomy for cervical cancer.Methods 120 cases of cervical cancer patients were selected as the research object,all the patients were divided into the observation group and the control group,each with 60 cases according to the random number table method.All patients were given laparoscopic pelvic autonomic nerve preservation hysterectomy,the con-trol group received anesthesia with propofol intervention,and the observation group received anesthesia with propofol and sevoflu-rane,the perioperative immune response and anesthesia effects were recorded.Results There were no significant difference com-pared between the 2 groups in operation time,intraoperative blood loss and lymph node clearance(P>0.05).The postoperative recovery time and postoperative hospital stay in the observation group were significantly less than those of the control group(P<0.05).The postoperative pelvic organ injury,urinary incontinence,urinary fistula,lymphatic cyst,thrombosis and complication rates in the observation group were 6.7%,and 10.0%in the control group,which had no significant difference(P>0.05).The recovery time and extubation time of the observation group were significantly less than that of the control group(P<0.05),and there was no significant difference in the amount of propofol compared between the 2 groups(P>0.05).The postoperative 48h CD4+CD25+T and CD4+OX40+T in the observation group were 5.85 ±1.33% and 8.52 ±3.17% respectively,and the control group were(7.14 ±1.04)% and(10.43 ±2.85)%,the difference compared between the 2 groups were significant(P <0.05),which were lower than that preoperative(P<0.05).Conclusion Propofol and sevoflurane anesthesia in laparoscopic hysterectomy surgery in the treatment of cervical cancer patients can reduce the immune response,improve the anesthetic effect,so as to promote the rehabilitation of patients.