七氟醚联合硬膜外麻醉对老年肺癌根治术患者ICAM-1及MMP-2的影响-现代医学

七氟醚联合硬膜外麻醉对老年肺癌根治术患者ICAM-1及MMP-2的影响

单位：空军军医大学唐都医院麻醉科, 陕西西安 710038

分类号：R734.2;R614.2

出版年·卷·期（页码）：2018·46·第十二期（1354-1359）

摘要：

目的：探讨七氟醚联合硬膜外麻醉对老年肺癌根治术患者细胞间黏附分子-1（ICAM-1）、基质金属酶-2（MMP-2）的影响。方法：将我院2016年10月至2017年10月84例行肺癌根治术的老年患者作为研究对象，将患者按随机数字表法分为观察组和对照组，每组42例。对照组患者采用七氟醚吸入麻醉，观察组患者采用七氟醚吸入麻醉联合硬膜外麻醉进行手术。比较两组患者手术指标、麻醉效果以及炎性因子、ICAM-1、MMP-2等表达水平。结果：观察组患者术后VAS评分低于对照组（P<0.05）；观察组术后苏醒时间短于对照组（P<0.05）；观察组术后1 d CD3⁺^、CD4⁺、CD8⁺、CD4⁺/CD8⁺、NK细胞百分比高于对照组（P<0.05）；观察组患者术后白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）水平低于对照组（P<0.05）；观察组患者手术期间ICAM-1、MMP-2水平低于对照组（P<0.05）。结论：七氟醚联合硬膜外麻醉能够降低术后应激反应，减轻术后炎症反应，降低肿瘤迁移相关因子ICAM-1、MMP-2的表达。

Objective: To investigate the effects of sevoflurane combined with epidural anesthesia on intercellular cell adhesion molecule-1 (ICAM-1) and matrix metalloproteinase-2 (MMP-2) in elderly patients undergoing radical resection of lung cancer. Methods:The elderly patients undergoing radical lung cancer surgery from October 2016 to October 2017 in our hospital were selected as subjects. Patients were divided into observation group and control group according to the random number table method, with 42 cases in each group. Patients in the control group received sevoflurane inhalation anesthesia. Patients in the observation group received sevoflurane inhalation anesthesia combined with epidural anesthesia for surgery. The operative parameters, anesthetic effects, and expression of inflammatory factors, ICAM-1, MMP-2 were compared between the two groups. Results:The VAS score in the observation group was lower than that in the control group (P<0.05). The recovery time in the observation group was shorter than that in the control group (P<0.05). The percentage of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ and NK cells were higher in the observation group than those in the control group 1 day after the operation(P<0.05); the levels of interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) in the observation group were lower than those in the control group (P<0.05). In the observation group, the levels of ICAM-1 and MMP-2 were lower than those in the control group (P<0.05). Conclusion:Sevoflurane combined with epidural anesthesia can reduce postoperative stress response, reduce postoperative inflammatory reaction, and reduce the expression of tumor migration-related factors ICAM-1 and MMP-2.

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