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Anesthesiology:丙泊酚静脉麻醉的结肠癌手术患者术后生存率高于地氟醚麻醉者

2018-11-30 王贵龙 “罂粟花”微信号

丙泊酚静脉麻醉的结肠癌手术患者的术后生存率较高,其与肿瘤TNM分期无明显关系。

背景与目的

研究表明麻醉药物对癌细胞的生长的影响不一,本研究旨在探讨择期结肠癌手术患者麻醉药物与术后生存率的关系。

方  法

本试验为回顾性分析,纳入 2005年1月-2014年12行择期结肠癌开放手术的患者,根据麻醉药物的不同分为两组:丙泊酚组与地氟烷组。排除标准:丙泊酚联合吸入或硬膜外麻醉、数据不完整、年龄小于20岁者。以手术日期为起点绘制生存曲线,根据倾向评分匹配分组后,应用单变量和多变量Cox回归模型比较两组死亡率。

结  果

地氟醚麻醉患者706例(307例死亡,43.5%),丙泊酚麻醉患者657例(88例死亡,13.4%);倾向评分匹配后,每组有579名患者(地氟醚组189人死亡,32.6%;丙泊酚组87人死亡,15%) ;地氟烷组术后肿瘤复发率(9.1%,5.8%; P = 0.021)、转移率(42.5%,16.7%,P < 0.001)、死亡率(43.5%,13.4%,P < 0.001)均高于丙泊酚组;丙泊酚组患者生存率(86.6%,56.5%)、无残疾生存率(99.8%,96.7%)均高于地氟烷组。

结  论

丙泊酚静脉麻醉的结肠癌手术患者的术后生存率较高,其与肿瘤TNM分期无明显关系。

原始出处:

Wu ZF, Lee MS, Wong CS, et al. Propofol-based Total Intravenous Anesthesia Is Associated with Better Survival Than Desflurane Anesthesia in Colon Cancer Surgery. Anesthesiology. 2018 Nov;129(5):932-941. doi: 10.1097/ALN.0000000000002357.

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    2019-03-03 fusion
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    2019-08-30 lsj628
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    2018-12-01 guoyibin
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    2018-12-01 skhzy

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