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Abstract：
To analyze the effects of different anaesthetic methods on perioperative cellular immunity and long-term outcome in patients who undergo esophageal cancer surgery.
METHODS: A total of 120 patients with esophageal cancer admitted to Zhengzhou University People\'s Hospital from January 2016 to January 2017 were recruited and randomly divided into a GA group (general anaesthesia, n = 40), a PG group (paravertebral nerve block with general anaesthesia, n = 40) and an EG group (epidural anaesthesia with general anaesthesia, n = 40).
METHODS: Self-rating anxiety scale and visual analogue scale scores were adopted to compare postoperative anxiety and the degree of pain of patients in the three groups. In addition, the adverse reactions of patients in the three groups were compared. The levels of interleukin-6 (IL-6), IL-4, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and the survival of T-cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+) before operation, at the end of operation, and on postoperative day (POD) 1 and POD 2 were measured by either ELISA or flow cytometry.
RESULTS: In the PG and EG group, the VAS scores were lower, and fewer opioids and vasoactive agents were used than in the GA group. In both the EG and PG groups, higher CD3+ and CD4+ cell survival and lower levels of Cor, IL-4, and IL-6 were identified at the end of or after the surgery than in the GA group. Moreover, the postoperative survival curves of the PG and EG groups were better than that of the GA group.
CONCLUSIONS: The combination of paravertebral nerve block or epidural anaesthesia and general anaesthesia may improve perioperative immune function and long-term outcome in patients who undergo esophageal cancer surgery.
METHODS: A total of 120 patients with esophageal cancer admitted to Zhengzhou University People\'s Hospital from January 2016 to January 2017 were recruited and randomly divided into a GA group (general anaesthesia, n = 40), a PG group (paravertebral nerve block with general anaesthesia, n = 40) and an EG group (epidural anaesthesia with general anaesthesia, n = 40).
METHODS: Self-rating anxiety scale and visual analogue scale scores were adopted to compare postoperative anxiety and the degree of pain of patients in the three groups. In addition, the adverse reactions of patients in the three groups were compared. The levels of interleukin-6 (IL-6), IL-4, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and the survival of T-cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+) before operation, at the end of operation, and on postoperative day (POD) 1 and POD 2 were measured by either ELISA or flow cytometry.
RESULTS: In the PG and EG group, the VAS scores were lower, and fewer opioids and vasoactive agents were used than in the GA group. In both the EG and PG groups, higher CD3+ and CD4+ cell survival and lower levels of Cor, IL-4, and IL-6 were identified at the end of or after the surgery than in the GA group. Moreover, the postoperative survival curves of the PG and EG groups were better than that of the GA group.
CONCLUSIONS: The combination of paravertebral nerve block or epidural anaesthesia and general anaesthesia may improve perioperative immune function and long-term outcome in patients who undergo esophageal cancer surgery.
摘要：
分析不同麻醉方法对食管癌手术患者围手术期细胞免疫及远期预后的影响。
方法:选取2016年1月至2017年1月郑州大学人民医院收治的120例食管癌患者,随机分为全麻n=40),PG组(全身麻醉椎旁神经阻滞，n=40）和EG组（全身麻醉的硬膜外麻醉，n=40)。
方法：采用焦虑自评量表和视觉模拟评分法比较3组患者术后焦虑和疼痛程度。此外,比较三组患者的不良反应。白细胞介素-6（IL-6）的水平，IL-4,肿瘤坏死因子-α(TNF-α),干扰素-γ（IFN-γ），和T细胞亚群的存活（CD3+，CD4+,CD8+,CD4+/CD8+)术前,在操作结束时，并在术后第1天（POD）1和POD2通过ELISA或流式细胞术进行测量。
结果：在PG和EG组中，VAS评分较低，与GA组相比，使用的阿片类药物和血管活性药物较少。在EG和PG组中，较高的CD3+和CD4+细胞存活率和较低水平的Cor，与GA组相比,在手术结束时或手术结束时鉴定出IL-4和IL-6。此外，PG组和EG组的术后生存曲线优于GA组。
结论：椎旁神经阻滞或硬膜外麻醉和全身麻醉的联合应用可改善食管癌手术患者的围手术期免疫功能和长期预后。
方法:选取2016年1月至2017年1月郑州大学人民医院收治的120例食管癌患者,随机分为全麻n=40),PG组(全身麻醉椎旁神经阻滞，n=40）和EG组（全身麻醉的硬膜外麻醉，n=40)。
方法：采用焦虑自评量表和视觉模拟评分法比较3组患者术后焦虑和疼痛程度。此外,比较三组患者的不良反应。白细胞介素-6（IL-6）的水平，IL-4,肿瘤坏死因子-α(TNF-α),干扰素-γ（IFN-γ），和T细胞亚群的存活（CD3+，CD4+,CD8+,CD4+/CD8+)术前,在操作结束时，并在术后第1天（POD）1和POD2通过ELISA或流式细胞术进行测量。
结果：在PG和EG组中，VAS评分较低，与GA组相比，使用的阿片类药物和血管活性药物较少。在EG和PG组中，较高的CD3+和CD4+细胞存活率和较低水平的Cor，与GA组相比,在手术结束时或手术结束时鉴定出IL-4和IL-6。此外，PG组和EG组的术后生存曲线优于GA组。
结论：椎旁神经阻滞或硬膜外麻醉和全身麻醉的联合应用可改善食管癌手术患者的围手术期免疫功能和长期预后。
