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编号:10969227
上腹部手术麻醉围手术期炎性细胞因子的影响
http://www.100md.com 《第四军医大学学报》 2005年第5期
IL6,,IL6;,IL8;,IL10;,麻醉,方法;,应激反应,1材料和方法,2结果,3讨论,【参考文献】
     【Abstract】 AIM: To evaluate the influence of different anesthetic techniques on the plasma levels of interleukin6 (IL6), interleukin8 (IL8) and interleukin10 (IL10) in patients undergoing major upper abdominal surgery. METHODS: Thirtytwo ASAⅠ-Ⅱ patients scheduled for major upper abdominal surgery were randomly divided into two groups: General anesthesia group (GA group, n=16), in which anesthesia was induced with fentanyl, propofol and vecuronium and maintained with fentanyl and vecuronium as well as enflurane inhalation. General combined epidural anesthesia group (GEA group, n=16): In which general anesthesia was used as in group GA and epidural block with 15 g/L lidocaine was performed before induction. The levels of plasma IL10, IL6 and IL8 were determined with an enzymelinked immunosorbent assay at preanesthsia, 0, 2 and 4 h during surgery and at the end of the surgery, followed by sampling on the morning of the first day and the third day postoperatively. RESULTS: Before anesthesia and 0 h of the surgery, no IL10 was detected. In all the patients, the plasma levels of IL10 showed significant elevations and achieved maximal value 4 h after the skin incision. The plasma levels of IL10 returned to preanesthesia levels on the third day postoperatively. The plasma levels of IL6 and IL8 also increased in the preioperative period. The plasma IL10 levels of group GEA were significantly lower than those of group GA on 4 h after the skin incision and the first day postoperatively. CONCLUSION: General anesthesia combined epidural block has a better inhibitory effect on the stress response in major upper abdominal surgery and may prevent the increase of inflammatory cytokine in the perioperative period. ......

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