摘要
目的 研究不同麻醉方法对手术病人红细胞免疫粘附功能及其调节因子的影响。方法 选择择期上腹部手术病例 6 0例 ,随机分为硬膜外麻醉组 (E组 )、全身麻醉组 (G组 )、全身麻醉联合硬膜外麻醉组 (联合麻醉组 ,GE组 ) ,每组 2 0例。分别于术前 1d、麻醉前、切皮后 1h、术后 1、3、7d采静脉血 ,测定各采样时点血浆循环免疫复合物 (CIC)水平、血浆β 内啡肽 (β EP)浓度、血浆红细胞CR1免疫粘附促进率 (RFER)和抑制率 (RFIR)、红细胞 酵母菌花环率 (RYRR)及红细胞 免疫复合物花环率 (R ICRR)。结果 (1)术后 1h、1、3dG组和E组RYRR比术前明显下降 (P <0 0 1) ,GE组术后 1h、1d也有下降 (P <0 0 5 ) ,术后 3d已恢复至术前水平 ,术后 1h、1、3dGE组与G组组间差异明显 (P <0 0 5 ,P <0 0 1) ;(2 )R ICRR在术后 1、3d三组均有明显增高 (P <0 0 5 ,P <0 0 1) ,但E组及GE组比G组增加幅度小 (P <0 0 5 ) ;(3)RFER和RFIR术后 1h、1、3d以G组变化最为显著 ,GE组变化程度比G组小 (P <0 0 5 ) ;(4 )血浆CIC含量在术后 1、3d三组均有明显增高 (P <0 0 5 ,P <0 0 1) ,但GE组比E组及G组增加幅度小 (P <0 0 5 ) ;(5 )三组血浆 β EP水平在麻醉前有增加 ,但与术前 1d相比无明显差异 (P >0 0 5 ) ,术后
Objective To study the effects of different anesthesia techniques on erythrocyte immune adherence function and its modulatory factors.Methods Sixty patients undergoing elective upper abdominal operation were enrolled and randomly allocated into three groups with 20 cases each:epidural group(E), general anesthesia group(G), epidural anesthesia group(GE).Venous blood samples were taken 1 day before operation,pre-anesthesia, at 1 h,on the 1st,3rd and 7th day after operation.The plasm content of circulating immune complex(CIC),the plasm level of β-endorphin(β-EP),the erythrocyte-yeast rosette rate(RYRR) and the erythrocyte immune complex rosette rate (R-ICRR),the plasm rosette forming enhancing ratio (RFER) and the rosette forming inhibitory ratio(RFIR) were measured.Results (1) RYRR in group G and E decreased significantly at 1 h,on the 1st and 3rd day following operation(P<0.01),which also reduced at 1 h and on the 1st day after operation in group GE(P<0.05).There was a marked difference between group GE and G at 1 h,on the 1st and 3rd day after operation(P<0.01,P<0.05).(2) R-ICRR increased in all three groups 1st and 3rd day after operation(P<0.01,P<0.05),but the increase in group GE and E was less than that in group G(P<0.05).(3) RFEF and RFIF in group G changed at 1 h,on the 1st and 3rd day following operation much more than those in group GE(P<0.05).(4) The content of plasm CIC increased in all three groups on the 1st d and 3rd day after operation(P<0.01,P<0.05),but the increase in group GE was less than that in group G and E (P<0.05).(5) The plasm level of β-EP in three groups increased pre-anesthesia,but there was no statistic difference as compared with that on the 1st day before operation.It increased in all three groups at 1h and on the 1st day after operation(P<0.01,P<0.05), but the increase in group GE was less than that in group G and E (P<0.01,P<0.05). Conclusion General anesthesia combined with epidural anesthesia can protect effectively erythrocyte immune adherence function from surgical stress and facilitate its early recovery.
出处
《临床麻醉学杂志》
CAS
CSCD
2004年第2期81-83,共3页
Journal of Clinical Anesthesiology
