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目的腹腔镜宫颈癌根治术是常见的妇科癌症手术,但手术对机体造成损伤,本研究探讨七氟醚和丙泊酚对行腹腔镜宫颈癌根治术患者炎症因子及应激反应的影响。方法选取2015年2月—2016年8月于浙江省肿瘤医院择期行腹腔镜宫颈癌根治术患者90例,随机对照表法分为观察组和对照组。观察组45例,行七氟醚吸入麻醉;对照组45例,行丙泊酚静脉输注麻醉。观察2组患者麻醉时间、自主呼吸恢复时间、睁眼时间、言语应答时间、定向力恢复时间、拔管时间,并进行记录。采用酶联免疫吸附法检测炎症因子肿瘤坏死因子(TNF-α)、白介素1β(IL-1β)水平,采用血压监测仪监测心率(HR)、平均动脉压(MAP),采用血糖仪检测血糖(GLU),采用放射免疫法检测皮质醇(COR)、血管紧张素Ⅱ(AngⅡ)水平,观察2组患者麻醉前(T0)、气腹后10 min(T1)、手术后10min(T2)上述指标变化情况。结果观察组自主呼吸恢复时间、睁眼时间、言语应答时间、定向力恢复时间、拔管时间均明显低于对照组(P<0.05);2组患者T1、T2时TNF-α、IL-1β均较T0时显著升高(P<0.05),但观察组TNF-α、IL-1β明显低于对照组(P<0.05);2组患者各时点HR、MAP差异均无统计学意义(P>0.05),2组患者T1、T2时GLU、CRO、AngⅡ均较T0时显著升高(P<0.05),但观察组T1、T2时GLU、CRO、AngⅡ明显低于对照组(P<0.05);观察组不良反应率为13.33%,对照组不良反应率为11.11%,2组不良反应发生率差异无统计学意义(χ~2=0.104,P>0.05)。结论七氟醚麻醉效果较好,可抑制手术产生的炎症反应和应激反应。
Objective To investigate the effect of sevoflurane and propofol on inflammatory factors and stress response in patients undergoing laparoscopic radical hysterectomy for cervical cancer. Methods From February 2015 to August 2016, 90 patients undergoing laparoscopic radical hysterectomy in Zhejiang Cancer Hospital were randomly divided into observation group and control group. In the observation group, 45 patients were anesthetized by sevoflurane inhalation; 45 patients in the control group were anesthetized by intravenous infusion of propofol. The anesthesia time, spontaneous breathing recovery time, eyes open time, speech response time, recovery time of orientational force and extubation time were observed and recorded. The levels of tumor necrosis factor (TNF-α) and interleukin-1β (IL-1β) were detected by enzyme-linked immunosorbent assay. Heart rate and mean arterial pressure were measured by blood pressure monitor. Blood glucose GLU). The levels of cortisol (COR) and angiotensin Ⅱ (Ang Ⅱ) were measured by radioimmunoassay. The levels of TUN, TUN, Changes. Results The recovery time of spontaneous breathing, eyes open time, speech response time, recovery time of orientational force and extubation time in the observation group were significantly lower than those in the control group (P <0.05). The levels of TNF-α, IL-1β (P <0.05), but the levels of TNF-α and IL-1β in the observation group were significantly lower than those in the control group (P <0.05). There were no significant differences in HR and MAP between the two groups (P <0.05). The GLU, CRO and Ang ¢ ò at T1 and T2 in both groups were significantly higher than those at T0 (P <0.05), but the GLU, CRO and Ang ¢ ò at T1 and T2 in observation group were significantly lower than those in control group 0.05). Adverse reaction rate was 13.33% in the observation group and 11.11% in the control group. There was no significant difference in adverse reaction between the two groups (χ ~ 2 = 0.104, P> 0.05). Conclusion Sevoflurane anesthesia is better, can inhibit the inflammatory reaction and stress response.