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炎症标志物在腹股沟疝手术中的预测价值:全身麻醉与脊髓麻醉对比

Predictive value of inflammatory markers in inguinal hernia surgery: General vs. spinal anesthesia.

作者信息

Kordić Marko, Kozomara Davorin, Mikulić Ivanka, Mikulić Vinka, Kajić Martin, Boras Miran, Bevanda Mateo, Soldo Neven, Jović Mijo, Dragišić Vedran, Rozić Ines

机构信息

Department of General Surgery, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.

Institute for Laboratory Diagnostics, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.

出版信息

Biomol Biomed. 2025 Jul 26;25(12):2819-2826. doi: 10.17305/bb.2025.12262.

Abstract

Inguinal hernia is a prevalent condition requiring surgical intervention, and accumulating evidence suggests that the type of anesthesia administered may influence systemic inflammatory responses. This study investigates the concentrations of inflammatory parameters in patients with inguinal hernia who underwent surgery utilizing either general or spinal anesthesia. The cohort comprised 87 male patients with inguinal hernia, classified as American Society of Anesthesiologists (ASA) physical status 1-2, who underwent elective surgical procedures. Participants were divided into two groups based on the anesthesia type: 44 received general anesthesia while 43 received spinal anesthesia. Plasma concentrations of leukocytes, C-reactive protein (CRP), interleukin-6 (IL-6), and lipopolysaccharide-binding protein (LBP) were quantified using automated immunoassays and a hematological analyzer. Standard parametric and non-parametric statistical tests were employed for data analysis, and the predictive capacity of select parameters, along with body mass index (BMI) and age, was assessed through Receiver Operating Characteristic (ROC) analysis with Area Under the Curve (AUC). Statistical analysis via the t-test identified significant differences in LBP concentrations (LBP 1, LBP 2, and LBP 3) between patients receiving general and spinal anesthesia. Correlation analysis of BMI and the measured parameters revealed statistically significant positive correlations for LBP 1 and LBP 2 in patients who underwent spinal anesthesia. Notably, the preoperative concentration of LBP, with a cutoff value exceeding 9.7 μg/mL, suggests a potentially superior approach with spinal anesthesia compared to general anesthesia, demonstrating 50% sensitivity and 81.4% specificity. Other parameters did not exhibit statistical significance in differentiating the type of anesthesia used for inguinal hernia surgery.

摘要

腹股沟疝是一种需要手术干预的常见病症,越来越多的证据表明,所采用的麻醉类型可能会影响全身炎症反应。本研究调查了接受全身麻醉或脊髓麻醉进行手术的腹股沟疝患者体内炎症参数的浓度。该队列包括87例腹股沟疝男性患者,其美国麻醉医师协会(ASA)身体状况分级为1-2级,接受了择期手术。根据麻醉类型将参与者分为两组:44例接受全身麻醉,43例接受脊髓麻醉。使用自动免疫测定法和血液分析仪对白细胞、C反应蛋白(CRP)、白细胞介素-6(IL-6)和脂多糖结合蛋白(LBP)的血浆浓度进行定量。数据分析采用标准参数和非参数统计检验,并通过曲线下面积(AUC)的受试者工作特征(ROC)分析评估选定参数以及体重指数(BMI)和年龄的预测能力。通过t检验进行的统计分析确定了接受全身麻醉和脊髓麻醉的患者之间LBP浓度(LBP 1、LBP 2和LBP 3)存在显著差异。对BMI与测量参数的相关性分析显示,接受脊髓麻醉的患者中LBP 1和LBP 2存在统计学上显著的正相关。值得注意的是,术前LBP浓度的临界值超过9.7μg/mL,这表明与全身麻醉相比,脊髓麻醉可能是一种更优的方法,其灵敏度为50%,特异性为81.4%。其他参数在区分腹股沟疝手术所使用的麻醉类型方面未显示出统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e08/12461272/6802c20ca73b/bb-2025-12262f1.jpg

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