硬膜外复合全麻对腹部手术患者血液循环及免疫功能的影响

Impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function in patients with abdominal surgery

目的探讨硬膜外复合全麻对腹部外科手术患者血流循环及免疫功能的影响。方法将90例行腹部手术患者随机分成实验组(应用硬膜外复合全麻)和对照组(单纯应用全身麻醉),每组45例。记录并比较2组的血流动力学及免疫功能的变化情况。结果实验组术毕时、术后12 h及术后1、2 d的SBP、DBP、HR、SpO2波动幅度均明显小于对照组(P<0.05);实验组术后6 h及术后1、3、5、7 d的CD3+、CD4+、CD4+/CD8+水平下降幅度均明显小于对照组(P<0.05)。结论硬膜外复合全麻较单纯全麻对患者的血流循环及免疫功能的影响更小,临床应用于腹部外科手术麻醉的前景良好。

Objective To investigate the impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function in patients with abdominal surgery.Methods Ninety patients with abdominal surgery were randomly divided into two groups,treatment group （n =45） and control group （n =45）.The control group was given general anesthesia only,and the treatment group was given epidural anaesthesia combined with general anesthesia.The changes of hemodynamic and the immune function in both groups were observed and compared.Results The fluctuation range of SBP,DBP,HR,SpO2 in the end of operation,12 hours after operation,ld and 2ds after operation in the treatment group were significantly less than the control group （P ＜ 0.05）.The decline of CD3＋,CD4＋,CD4＋/CD8＋ 6 hours after operation,1d,3 ds,5 ds and 7 ds after operation in the treatment group were significantly less than the control group （P ＜ 0.05）.Conclusion The impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function is significantly smaller in patients with abdominal surgery,and the epidural anaesthesia combined with general anesthesia has good prospects in abdominal surgery.