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