靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能的影响研究

目的：探讨靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能的影响。方法：选择在我院行直肠癌根治术的72例患者，将其分为观察组和对照组各36例，其中观察组给予靶控输注静脉麻醉，对照组采用腰硬联合麻醉，对两组患者手术时间、术中出血量以及免疫球蛋白水平（IgG、IgA、IgM）、血清白介素-6水平（IL-6）、肿瘤坏死因子α水平（TNF-α）以及T细胞亚群（CD3、CD4）水平进行对比。结果：观察组手术平均时间为（130．5±11．7）min，术中平均出血量为（271.3±37．8）ml，与对照组比较差异均无统计学意义（P〉0．05）；两组IgG、IgA及IgM，在T1、T2、T3及T4时刻水平比较差异均无统计学意义（P〉0．05）；两组IL-6、TNF-α、CD3及CD4在麻醉后较T1时均有明显变化，比较差异均有统计学意义（P〈0．05），且观察组变化较对照组更为明显，两组比较差异有统计学意义（P〈0．05）。结论：靶控输注静脉麻醉和腰硬联合麻醉对直肠癌根治术患者免疫功能均存在抑制作用，且以抑制细胞免疫功能为主，而腰硬联合麻醉抑制作用较低，值得推广应用。

The Study of Target-Controlled Infusion Intravenous Anesthesia and Epidural Anesthesia on Immune Function of the Patients with Colorectal Cancer Resection

Objective： To investigate the target-controlled infusion intravenous anesthesia and epidural anesthesia on immune function of the patients with colorectal cancer resection. Methods： 72 patients with colorectal cancer resection were divided into observation group and control group, and 36 cases were in each group, the observation group was given target controlled infusion intravenous anesthesia while the control group was received lumbar epidural anesthesia, the operative time, blood loss, and immunoglobulin levels （IgG, IgA, IgM）, serum levels of interleukin-6 （IL-6）, tumor necrosis factor-a levels （TNF -α） and T-cell subsets （CD3, CD4） levels were compared between the two groups. Results： The mean operative time of the observation group was （130.5± 11.7） min, mean intraoperative blood loss was （271.3± 37.8） mL, and it showed no significant difference compared with the control group （P〉0.05）; the IgG, IgA and IgM at T1, T2, T3 and T4 levels had no significant difference （P〉0.05）; IL-6, TNF-α, CD3 and CD4 after anesthesia changed significantly compared with T1, the differences were statistically significant （P〈0.05）, and changes in the observation group was significant than the control group, the difference was statistically significant （P〈0.05）. Conclusion： Target-controlled infusion intravenous anesthesia and epidural anesthesia on immune function for patients with colorectal cancer resection are present inhibition, and it can suppress immune function-based, and the inhibition of epidural anesthesia is low, which is should be widely applied in clinical.