高级检索

全身麻醉联合硬膜外麻醉对结直肠癌患者脑肠肽、肠屏障功能及氧化应激反应的影响

肖俊, 张洁

肖俊, 张洁. 全身麻醉联合硬膜外麻醉对结直肠癌患者脑肠肽、肠屏障功能及氧化应激反应的影响[J]. 实用临床医药杂志, 2020, 24(8): 58-62. DOI: 10.7619/jcmp.202008015
引用本文: 肖俊, 张洁. 全身麻醉联合硬膜外麻醉对结直肠癌患者脑肠肽、肠屏障功能及氧化应激反应的影响[J]. 实用临床医药杂志, 2020, 24(8): 58-62. DOI: 10.7619/jcmp.202008015
shu
XIAO Jun, ZHANG Jie. Effects of general anesthesia combined with epidural anesthesia on brain gut peptide, intestinal barrier function and oxidative stress in patients with colorectal cancer[J]. Journal of Clinical Medicine in Practice, 2020, 24(8): 58-62. DOI: 10.7619/jcmp.202008015
Citation: XIAO Jun, ZHANG Jie. Effects of general anesthesia combined with epidural anesthesia on brain gut peptide, intestinal barrier function and oxidative stress in patients with colorectal cancer[J]. Journal of Clinical Medicine in Practice, 2020, 24(8): 58-62. DOI: 10.7619/jcmp.202008015
shu

全身麻醉联合硬膜外麻醉对结直肠癌患者脑肠肽、肠屏障功能及氧化应激反应的影响

  • 复旦大学附属华山医院北院 麻醉科, 上海, 201907

基金项目: 

上海市卫生和计划生育委员会科研课题计划项目(201740008)

详细信息

  • 中图分类号: R735.3

Effects of general anesthesia combined with epidural anesthesia on brain gut peptide, intestinal barrier function and oxidative stress in patients with colorectal cancer

  • Department of Anesthesiology, North Division of Huashan Hospital Affiliated to Fudan University, Shanghai, 201907

摘要

    摘要
  • 摘要: 目的 分析全身麻醉联合硬膜外麻醉对结直肠癌患者脑肠肽、肠屏障功能及氧化应激反应的影响。 方法 选择本院行根治性手术的86例结直肠癌患者为研究对象,均经病理学检查确诊为结直肠癌。采用随机数字表法将患者分为2组,其中将采用单纯全身麻醉的43例患者纳入对照组,全身麻醉联合硬膜外麻醉的43例患者纳入观察组。对比2组患者脑肠肽、肠屏障功能及氧化应激反应指标。 结果 术前, 2组患者胃动素、胃泌素及饥饿素比较差异无统计学意义(P>0.05)。术后,观察组胃动素及饥饿素水平均显著高于对照组(P<0.05), 但2组胃泌素对比差异无统计学意义(P>0.05)。术前, 2组患者血清二胺氧化酶、D-乳酸及内毒素对比差异无统计学意义(P>0.05); 治疗后, 2组患者以上指标水平均显著下降,但对照组下降幅度更大(P<0.05)。治疗后, 2组患者超氧化物歧化酶(SOD)、谷胱甘肽(GSH)均显著升高,但对照组升高幅度更大(P<0.05); 治疗后, 2组患者血清丙二醛(MDA)水平均呈显著下降趋势,但对照组下降更显著(P<0.05)。 结论 与单纯全身麻醉相比,全身麻醉联合硬膜外麻醉可减少对结直肠癌患者脑肠肽、肠屏障功能及氧化应激反应的影响。
    Abstract: Objective To analyze the effects of general anesthesia combined with epidural anesthesia on brain-gut peptide, intestinal barrier function and oxidative stress in patients with colorectal cancer. Methods Eighty-six patients with colorectal cancer who undergoing radical surgery in our hospital were enrolled as study objects, and were confirmed as colorectal cancer by pathological examination. Patients were divided into two groups by random number table method, among whom 43 cases with general anesthesia were selected as control group, and another 43 patients combining general anesthesia and epidural anesthesia were selected as observation group. The brain intestinal peptide, intestinal barrier function and oxidative stress response index were compared between the two groups. Results There were no significant differences in motilin, gastrin and ghrelin between the two groups before operation(P>0.05). The levels of motilin and ghrelin after operation in the observation group were significantly higher than those in the control group(P<0.05), but no significant difference in gastrin was observed between the two groups(P>0.05). There were no significant differences in serum diamine oxidase, D-lactate and endotoxin between the two groups before operation(P>0.05). After treatment, the above indicators in the two groups decreased significantly, but the control group decreased more significantly(P<0.05). After treatment, the superoxide dismutase - (SOD), glutathione(GSH)of the two groups were significantly increased, but the control group increased more significantly(P<0.05). After treatment, the serum malondialdehyde(MDA)level of the two groups showed a significant decrease trend, but the control group decreased more significantly(P<0.05). Conclusion Compared with general anesthesia alone, general anesthesia combined with epidural anesthesia can reduce the effects on brain gut peptide, intestinal barrier function and oxidative stress in colorectal cancer patients.
    • HTML全文
    • 参考文献(20)

  • Chen W K, Ren L, Wei Y, et al. General anesthesia combined with epidural anesthesia ameliorates the effect of fast-track surgery by mitigating immunosuppression and facilitating intestinal functional recovery in colon cancer patients[J]. Int J Colorectal Dis, 2015, 30(4): 475-481.

    Handley G H, Silbert B S, Mooney P H, et al. Combined general and epidural anesthesia versus general anesthesia for major abdominal surgery: postanesthesia recovery characteristics[J]. Reg Anesth, 1997, 22(5): 435-441.

    Hung M H, Chan K C, Liu Y J, et al. Nonintubated thoracoscopic lobectomy for lung cancer using epidural anesthesia and intercostal blockade: a retrospective cohort study of 238 cases[J]. Medicine(Baltimore), 2015, 94(13): e727.

    Yu Y N, Dong J, Xu Z F, et al. Pleth variability index-directed fluid management in abdominal surgery under combined general and epidural anesthesia[J]. J Clin Monit Comput, 2015, 29(1): 47-52.

    Bardia A, Sood A, Mahmood F, et al. Combined epidural-general anesthesia vs general anesthesia alone for elective abdominal aortic aneurysm repair[J]. JAMA Surg, 2016, 151(12): 1116-1123.

    Drummond J C, Krane E J, Tomatsu S, et al. Paraplegia after epidural-general anesthesia in a Morquio patient with moderate thoracic spinal Stenosis[J]. J Can D'anesthesie, 2015, 62(1): 45-49.

    Piegeler T, Beck-Schimmer B. Anesthesia and colorectal cancer - The perioperative period as a window of opportunity[J]. Eur J Surg Oncol, 2016, 42(9): 1286-1295.

    Gu C Y, Zhang J, Qian Y N, et al. Effects of epidural anesthesia and postoperative epidural analgesia on immune function in esophageal carcinoma patients undergoing thoracic surgery[J]. Mol Clin Oncol, 2015, 3(1): 190-196.

    Zawar B P, Mehta Y, Juneja R, et al. Nonanalgesic benefits of combined thoracic epidural analgesia with general anesthesia in high risk elderly off pump coronary artery bypass patients[J]. Ann Card Anaesth, 2015, 18(3): 385-391.
    李坤, 曹廷宝, 孔延龙, 等. 腹腔镜胃癌根治术对术后胃肠动力恢复及胃肠激素的影响研究[J]. 中国普外基础与临床杂志, 2016, 23(8): 936-939.
    许正国, 郭世伟, 金鹏程. 腹腔镜结直肠癌根治术患者围术期机体代谢及胃肠功能的变化观察[J]. 中国医师杂志, 2018(3): 391-393.
    刘信毅, 方军, 王江铃. 腰硬联合麻醉和硬膜外麻醉对子宫全切术麻醉效果及对血清胃动素和胃泌素的变化影响[J]. 世界华人消化杂志, 2018, 26(35): 2071-2076.

    Wang X T, Lv M, Guo H Y. Effects of epidural block combined with general anesthesia on antitumor characteristics of T helper cells in hepatocellular carcinoma patients[J]. J Biol Regul Homeost Agents, 2016, 30(1): 67-77.
    Apan A, Cuva瘙塂Apan Ö, Köse E A. Segmental epidural anesthesia for percutaneous kyphoplasty: comparison with general anesthesia[J]. Turk J Med Sci, 2016, 46(6): 1801-1807.

    Sun X Z, Yang C Z, Li K Z, et al. The impact of anesthetic techniques on survival for patients with colorectal cancer: evidence based on six studies[J]. Hepatogastroenterology, 2015, 62(138): 299-302.

    Xu Q, Shi N J, Zhang H, et al. Effects of combined general-epidural anesthesia and total intravenous anesthesia on cellular immunity and prognosis in patients with non?small cell lung cancer: a comparative study[J]. Mol Med Rep, 2017, 16(4): 4445-4454.

    Anschütz M, Drautz J, Kafka-Ritsch R. Effect of perioperative epidural anesthesia in elective laparoscopic colorectal resections[J]. Eur Surg, 2015, 47(2): 53-55.

    Zabolotskikh I, Trembach N. Safety and efficacy of combined epidural/general anesthesia during major abdominal surgery in patients with increased intracranial pressure: a cohort study[J]. BMC Anesthesiol, 2015, 15: 76.

    Donmez T, Erdem V M, Uzman S, et al. Laparoscopic cholecystectomy under spinal-epidural anesthesia vs. general anaesthesia: a prospective randomised study[J]. Ann Surg Treat Res, 2017, 92(3): 136-142.

    Zhu J, Zhang X R, Yang H. Effects of combined epidural and general anesthesia on intraoperative hemodynamic responses, postoperative cellular immunity, and prognosis in patients with gallbladder cancer: a randomized controlled trial[J]. Medicine(Baltimore), 2017, 96(10): e6137.
    • 相关文章
    • 施引文献(12)

  • 期刊类型引用(11)

    1. 杨明宝. 硬膜外麻醉复合全麻对结直肠癌手术患者组织氧合、麻醉用药剂量的影响分析. 黑龙江医学. 2023(18): 2225-2228 . 百度学术
    2. 胡延伟，连彦军，秦朔，张晓伟，范现英，宋志岗. 经自然腔道内镜标本取出术对结直肠癌患者围术期指标、肠道屏障功能及排便情况的影响. 现代消化及介入诊疗. 2023(07): 900-903 . 百度学术
    3. 陶学有，乔庆成，宁妮，顾海燕，葛倩，李冬，戴阳，陈娟. 不同麻醉方式对腹腔镜下子宫内膜癌分期手术患者的影响. 中外医学研究. 2023(32): 132-135 . 百度学术
    4. 孙磊. 全身麻醉联合硬膜外麻醉在腹腔镜下直肠癌根治术中的效果. 中外医学研究. 2023(33): 113-117 . 百度学术
    5. 侯雪. 硬膜外麻醉复合全身麻醉用于直肠癌根治手术的麻醉效果观察. 航空航天医学杂志. 2022(06): 679-682 . 百度学术
    6. 王小明，余珊，陈欣，王光洁，孙雨欣，倪娜，张慈. 早期结直肠癌超声内镜检查及内镜黏膜下剥离术的临床价值. 蚌埠医学院学报. 2022(08): 1034-1037 . 百度学术
    7. 林育南，杨瑞敏，肖志凌. 超声引导下腹横肌平面阻滞联合腹直肌鞘阻滞在结直肠癌根治术围术期镇痛中的应用. 微创医学. 2021(01): 21-23+89 . 百度学术
    8. 陈冯琳，项海华，林洁. 氢吗啡酮对结直肠癌根治术后患者早期恢复、术后镇痛及应激反应的影响. 中国基层医药. 2021(10): 1486-1489 . 百度学术
    9. 唐炜，季锋，袁岚. 电针预处理对胃癌根治术患者术后应激反应、肠黏膜功能及炎性因子水平的影响. 实用临床医药杂志. 2021(16): 40-44 . 本站查看
    10. 程晓丹. 全身麻醉复合硬膜外麻醉在腹腔镜结肠癌根治手术中的麻醉效果分析. 中国现代药物应用. 2021(18): 50-52 . 百度学术
    11. 沈秋菊，金顺德，曹亮，韩娟. 腹腔镜直肠癌根治术对患者血清免疫球蛋白水平及肠道屏障功能的影响. 山东医药. 2021(29): 70-72 . 百度学术

    其他类型引用(1)

    • 资源附件(0)
计量
  • 文章访问数: 
  • HTML全文浏览量: 
  • PDF下载量: 
  • 被引次数: 12
出版历程
  • 收稿日期:  2020-01-03

目录

摘要
HTML全文
    参考文献(20)
    相关文章
    施引文献
    资源附件(0)

    /

    返回文章
    返回

    © 2020 《实用临床医药杂志》编辑部

    地址：江苏省扬州市江阳中路136号，扬州大学江阳路北校区14号楼201室邮编：225009电话：0514-87978917、87978989、87978807

    苏公网安备 32100302010246号

    本系统由 北京仁和汇智信息技术有限公司 开发  百度统计