Yu Jianmin, Han Mingfen, Geng Jun
Jianmin Yu, Department of Anesthesiology III, Binzhou People's Hospital, Shandong, 256610, China.
Mingfen Han, Department of Anesthesiology III, Binzhou People's Hospital, Shandong, 256610, China.
Pak J Med Sci. 2019;35(3):780-785. doi: 10.12669/pjms.35.3.590.
To analyze the changes of hemorheology, haemodynamics and immune function of patients during propofol intravenous anesthesia in the radical resection of colorectal carcinoma and its significance.
The study included 112 patients who underwent radical resection of colorectal carcinoma in our hospital between August 2016 and December 2017, and they were divided into an observation group (N=56) and a control group (N=56) using random number table. Patients in the observation group were given propofol intravenous anesthesia, while patients in the control group received inhalation anesthesia of sevoflurane. Hemorheological and haemodynamical indexes were compared and analyzed before anesthesia (T0), 90 min after induction (T1), 150 min after induction (T2) and 30 min after entering post-anesthesia care unit (T3), and the changes of immune function before and after surgery was also observed.
The whole blood viscosity under high, medium and low shear rates of the observation group declined significantly compared to that of the control group at T1, T2 and T3 (P<0.05). The heart rate (HR) and systolic pressure (SPB) of the observation group significantly decreased at T2 compared to those at T1 (P<0.05), but recovered to the level observed at T0 at T3. The diastolic blood pressure (DBP) of the two groups at T1, T2 and T3 was not significantly different with that at T0 (P>0.05). The levels of CD45RA+ and CD45RO+ of both groups had a significant decrease at the end of the surgery compared to before anesthesia (P<0.05); the levels of the observation group recovered at the postoperative 72 h, and the differences with the levels before anesthesia had no statistical significance (P>0.05); the level of CD45RA+ of the control group also recovered at the postoperative 72 h, but the difference with the level before anesthesia had no statistical significance (P>0.05); the level of CD45RO+ of the control group had a significant decrease, and the difference with the level before anesthesia was statistically significant (P<0.05). The level of CD45RA+/CD45RO+ of the observation group at the end of surgery and the postoperative 72 h was not significantly different with those before anesthesia (P>0.05). The level of CD45RA+/CD45RO+ of the control group at the postoperative 72 h showed a significant increase compared to before anesthesia (P<0.05).
Propofol intravenous anesthesia has a significant improvement effect on hemorheology before radical resection of colorectal carcinoma and has a small influence on haemodynamics. Moreover it is beneficial to the recovery of immune function. The therapy is worth promotion.
分析结直肠癌根治术中丙泊酚静脉麻醉患者血液流变学、血流动力学及免疫功能的变化及其意义。
选取2016年8月至2017年12月在我院行结直肠癌根治术的112例患者,采用随机数字表法分为观察组(N = 56)和对照组(N = 56)。观察组患者给予丙泊酚静脉麻醉,对照组患者采用七氟醚吸入麻醉。比较并分析麻醉前(T0)、诱导后90 min(T1)、诱导后150 min(T2)及进入麻醉后恢复室30 min(T3)时的血液流变学和血流动力学指标,并观察手术前后免疫功能的变化。
观察组在T1、T2及T3时高、中、低切变率下的全血黏度均较对照组显著下降(P < 0.05)。观察组T2时心率(HR)和收缩压(SPB)较T1时显著降低(P < 0.05),但T3时恢复至T0时水平。两组在T1、T2及T3时的舒张压(DBP)与T0时相比差异无统计学意义(P > 0.05)。两组手术结束时CD45RA +和CD45RO +水平均较麻醉前显著降低(P < 0.05);观察组术后72 h恢复,与麻醉前水平相比差异无统计学意义(P > 0.05);对照组术后72 h CD45RA +水平也恢复,但与麻醉前水平相比差异无统计学意义(P > 0.05);对照组CD45RO +水平显著降低,与麻醉前水平相比差异有统计学意义(P < 0.05)。观察组手术结束时及术后72 h的CD45RA +/CD45RO +水平与麻醉前相比差异无统计学意义(P > 0.05)。对照组术后72 h的CD45RA +/CD45RO +水平较麻醉前显著升高(P < < 0.05)。
丙泊酚静脉麻醉对结直肠癌根治术前血液流变学有显著改善作用,对血流动力学影响较小,且有利于免疫功能恢复,值得推广应用。