下腹部手术后自控镇痛的疗效及对血清补体系统的影响

The Effects of Patient-controlled Epidural Analgesia on Their Immune Function after Lower Abdominal Surgery

目的:探讨硬膜外自控镇痛(PCEA)对下腹部手术后自控镇痛的疗效及对血清补体C3和C4的影响。方法:选择择期施行下腹部手术的患者60例,其中30例于术后行PCEA(PCEA组),另30例于术后肌内注射镇痛药止痛(对照组)。比较2组病例的镇痛效果,并分别测定术前12h及术后12、24、48h时补体C3、C4含量。结果:PCEA组患者术后伤口疼痛明显减轻;术后12h2组患者补体C3、C4含量均下降,术后48hPCEA组补体C3、C4含量回升,而对照组仍处于低水平。结论:下腹部手术后施行PCEA能有效地减轻术后伤口的疼痛,并能减轻应激反应所致的免疫抑制,从而保护机体的免疫功能,有利于机体的康复。

Objective： To explore the effects of PCEA on the patients＇complement C3 and C4 after lower abdominal surgery. Methods：60 patients undergoing lower abdominal surgery were chosen. At the end of the operations, the epidural catheters were detained in 30 patients, through which the PCEA was given （PCEA group）. The other 30 patients received pethidine via IM on demand without the epidural catheter after surgery （control group）. The degrees of postoperative pain in both groups were compared. The blood samples of both groups were obtained 12h before operation , and 12,24,48h after surgery, and were assessed complement C3 and C4. Results： Patients in PCEA group appeared significant pain release after surgery. After operation the levels of C3 and C4 were decreased in both group except at 48h after surgery in PCEA group. Conclusions： Postoperative pain management with PCEA can reduce wound pain effectively and reduce stress-induced immune inhibition. PCEA can protect body immunity and beneficial for recovery.