摘要
目的:研究全身麻醉复合硬膜外麻醉对腹腔镜胆囊切除术患者术后免疫功能、应激状态及凝血功能的影响。方法:选择2014年5月~2016年8月期间在陕西省安康市汉滨区第一医院接受择期腹腔镜胆囊切除术的98例患者,随机分为接受全身麻醉复合硬膜外麻醉的复合麻醉组以及接受全身静脉麻醉的全身麻醉组,术后采集外周血并测定CD3^+CD4^+CD8-T细胞、CD3^+CD4-CD8^+T细胞、CD16^+CD56^+NK细胞、CD3-CD19^+B细胞的数目,采集血清并测定应激相关内分泌激素NE、Cor、Ins、C-P、FT3、FT4以及凝血功能指标TXA2、TXB2、PGI2、6-K-PGI1α的含量。结果:复合麻醉组患者外周血中CD3^+CD4^+CD8-T细胞、CD3^+CD4-CD8^+T细胞、CD16^+CD56^+NK细胞、CD3-CD19^+B细胞的数目均显著高于静脉麻醉组;复合麻醉组患者血清中NE、Cor、Ins、C-P、FT3、FT4、TXA2、TXB2的含量均显著低于静脉麻醉组,PGI2、6-K-PGI1α的含量均显著高于静脉麻醉组。结论:全身麻醉复合硬膜外麻醉能够改善腹腔镜胆囊切除术患者术后的免疫功能、应激状态和高凝状态。
Objective： To study the effect of general anesthesia combined with epidural anesthesia on the postoperative immune function, stress state and coagulation function in patients with laparoscopic cholecystectomy.Methods： A total of 98 patients undergoing selective laparoscopic cholecystectomy in our hospital between May 2014 and August 2016 were selected and randomly divided into the combined anesthesia group who accepted the general anesthesia combined with epidural anesthesia and the general anesthesia group who accepted the total intravenous anesthesia, peripheral blood was collected after operation to detect the number of CD3^＋CD4^＋CD8^-T cells, CD3^＋CD4^-CD8^＋T cells, CD16＋CD56＋NK cells and CD3-CD19＋B cells, serum was collected to detect the levels of stress-related endocrine hormones NE, Cor, Ins, C-P, FT3 and FT4 as well as coagulation function indexes TXA2, TXB2, PGI2 and 6-K-PGI1α.Results： The number of CD3^＋CD4^＋CD8^-T cells, CD3^＋CD4^-CD8^＋T cells, CD16＋CD56＋NK cells and CD3-CD19＋B cells in peripheral blood of combined anesthesia group were significantly higher than those of intravenous anesthesia group;serum NE, Cor, Ins, C-P, FT3, FT4, TXA2 and TXB2 levels of combined anesthesia group were significantly lower than those of intravenous anesthesia group while PGI2 and 6-K-PGI1α levels were significantly higher than those of intravenous anesthesia group.Conclusions： General anesthesia combined with epidural anesthesia can improve the postoperative immune function, stress state and hypercoagulable state in patients with laparoscopic cholecystectomy.
出处
《海南医学院学报》
CAS
2017年第5期676-679,共4页
Journal of Hainan Medical University
基金
陕西省社会发展科技公关项目(2016SF-228)~~
