不同麻醉方法腹腔镜下卵巢肿瘤剥除对患者红细胞免疫功能的影响

Effects of different anesthesia and analgesia on erythrocyte immune function of patients with ovarian benign tumor treated by laparoscopic therapeutic

目的:探讨静脉全麻和静脉全麻复合硬膜外麻醉对腹腔镜下行卵巢肿瘤剥除术患者红细胞免疫功能的影响。方法:收集行腹腔镜下卵巢肿瘤剥除术患者120例,随机分成全麻复合硬膜外麻醉(A组)和静脉全麻(B组)两组,每组60例。分别于麻醉前(T0)、麻醉后30 min(T1)、术中1 h(T2)、术后24 h(T3)、术后48 h(T4)、术后72 h(T5)6个时间点抽取时静脉血。检测各时间点红细胞免疫功能指标:红细胞C3b受体花结率(RRCR)、红细胞免疫复合物药结率(RRICR)、肿瘤红细胞花结率(RTRR)。结果:两组患者的RRCR、RRICR及RTRR均于T1开始下降,与T0比较差异存在显著性(P<0.05);RRCR于T4时下降至最低点,RRICR及RTRR于T3时下降至最低点,于T5时RRCR、RRICR及RTRR均恢复T0水平。组间比较,两组患者于T0时RRCR、RRICR及RTRR比较,差异无统计学意义(P>0.05),T1至T4时两组患者的RRCR、RRICR及RTRR比较,差异均有统计学意义,以B组下降更明显(P<0.05)。结论:麻醉对腹腔镜卵巢肿瘤剥除术患者的红细胞免疫功能有损伤作用,静脉全麻复合硬膜外麻醉对红细胞免疫功能的影响相对较小。

AIM： To investigate the effects of different anesthesia and analgesia on erythrocyte immune function of patients with ovarian benign tumor treated by laparoscopic therapeutic.METHODS： 120 patients with ovarian benign tumor treated by laparoscopic therapeutic were randomly divided into two groups with 60 cases each.In group A,patients received general anesthesia eombined with thoracic epidural anesthesia during surgery,patients in group B received general anesthesia.The cervical venous blood samples were obtained at the following time points： before induction of anesthesia（T0）,30 min after anesthesia（T1）,1 h during operation（T2）,24 h after operation（T3）,48 h after operation（T4） and 72h after operation（T5）.RRCR,RRICR and RTRR were measured at different time points.RESULTS： RRCR,RRICR and RTRR in two groups decreased significantly from T1（P0.05）.RRCR in two groups was on the low-water mark at T4 and RRICR,RTRR was on the low-water mark at T3.There were no significantly different of RRCR,RRICR and RTRR in two groups at T0.There were significantly different of RRCR,RRICR and RTRR in two groups from T1 to T4（P0.05）,the increase in group A was less than that in group B（P0.05）.CONCLUSION： Anesthesia may harm on erythroeyte immune function of patients with ovarian benign tumor treated by laparoscopic therapeutic.The effect of general anesthesia combined with thoraeic epidural anesthesia on erythrocyte immune function was less.