摘要
目的研究不同浓度左布比卡因硬膜外输注对结肠癌根治术后患者免疫功能的影响。方法纳入本院96例结肠癌根治术患者为研究对象,随机均分为A组(0.25%左布比卡因组)、B组(0.5%左布比卡因组)、C组(0.75%左布比卡因组)。对比三组麻醉效果,记录三组术前、术后即刻、术后1 d、术后3 d平均动脉压(MAP)、血清皮质醇(Cor)水平及免疫功能指标变化。结果 B、C组感觉、运动阻滞起效时间均短于A组,感觉、运动阻滞维持时间均长于A组(P<0.05)。A、B、C三组术后即刻MAP水平呈递减趋势(P<0.05)。B、C组术后即刻、术后1 d、术后3 d血清Cor水平均显著低于A组(P<0.05),B、C组比较无显著差异(P>0.05)。B、C组术后1 d、术后3 d CD3+、CD4+、CD4+/CD8+均低于A组(P<0.05),B、C组比较无显著差异(P>0.05)。结论与0.25%左布比卡相比,0.5%左布比卡因应用于结肠癌根治术麻醉效果好、应激反应轻,且对免疫功能的影响小;与0.75%左布比卡比较,其对血流动力学影响更小,具有较好的临床应用价值。
Objective To study the effects of different concentrations of levobupivacaine on postoperative immune function in patients undergoing radical resection of colon cancer. Methods 96 patients with colon cancer were recruited as study subjects. They were randomly assigned to group A（0.25% left bupivacaine group）,group B（0.5% left bupivacaine group）and group C（0.75% levobupivacaine group）. The anesthetic effect of three groups was compared. Preoperative,immediate postoperative,1 d and 3 d postoperative,the mean arterial pressure（MAP）,serum cortisol（Cor）level and immune function index of three groups were recorded. Results The onset time of sensory and motor block in group B and group C was shorter than that of group A. The sensory and motor block maintenance time of group B and group C were longer than those of group A（P〈0. 05）. Immediate postoperative,group A,group B and group C showed a decrease in the level of MAP（P〈0. 05）. Immediate postoperative,1d and 3d postoperative,the serum Cor levels in group B and C were significantly lower than those in group A（P〈0. 05）. There was no significant difference between B group and C group（P〉0. 05）. Conclusion Compared with 0.25% levobupivacaine,0.5% levobupivacaine in resection of colon cancer have good effect of anesthesia,stress reactions,and effect on immune function. Compared with 0.75% left bupivacaine,it has less impact on hemodynamics. 0.5% levobupivacaine has good value for clinical application.
作者
杨海龙
杨祎
Yang Hailong Yang Yi(Department of Anesthesiology, Baoji Central Hospital, Baoji, Shaanxi, 721000, China)
出处
《结直肠肛门外科》
2017年第3期382-385,共4页
Journal of Colorectal & Anal Surgery
关键词
左布比卡因
硬膜外麻醉
结肠癌根治术
免疫
Levobupivacaine
epidural anesthesia
radical resection of colon cancer
immunity
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