硬膜外麻醉复合全凭静脉麻醉对老年腹部手术患者免疫功能的影响

Effect of epidural anesthesia combined with total intravenous anesthesia on immune function in senile patients with abdominal surgery

目的探讨硬膜外麻醉复合全凭静脉麻醉对老年腹部手术患者免疫功能的影响。方法回顾性分析2017年5月至12月在某院行腹部手术治疗的老年患者104例临床资料,按照不同麻醉方式将其分为对照组和观察组,各52例。观察组行硬膜外麻醉复合全凭静脉麻醉,对照组行全凭静脉麻醉。观察两组免疫功能、呼吸功能及麻醉后恢复情况。结果对照组术后6 h、24 h CD3^+、CD4^+水平比观察组低,CD8^+比观察组高,差异有统计学意义(P<0.05);对照组拔管后血氧饱和度、通气量比观察组低,呼吸频率比观察组高,差异有统计学意义(P<0.05);对照组苏醒时间、自主呼吸时间及拔管时间均比观察组高,差异有统计学意义(P<0.05)。结论硬膜外麻醉复合全凭静脉麻醉可有效保护患者的呼吸功能,改善机体免疫功能,缩短患者麻醉苏醒时间及拔管时间,利于患者术后康复。

Objective To investigate the effect of epidural anesthesia combined with total intravenous anesthesia (TIVA)on immune function in senile patients with abdominal surgery.Methods The clinical data of 104 senile patents with abdominal surgery from May to December,2017 were retrospectively analyzed.The patients were divided into the control group and the observation group by different anesthesia methods with 52 cases in each group.The Observadon group was given epidural anesthesia combined with TIVA while the control group was given TWA.The immune function,respiratory function,post-anesthesia recovery in two groups were observed.Results The CD3^+ and CD4^+ levels 6h and 24h after the operation of the control group were lower than those in the observation group and the level of CD8^+ in the control group was higher than that of the observation groupt.The difference showed statistical significance (P <0.05).After extubation,the oxygen saturation and ventilation volume in the control group were lower than .those in the observation group while the respiratory rate of the control group was higher than that of the observation group.The difference showed statistical significance (P <0.05).The awakening time,spontaneous breathing time, extubation time in the control group were higher than those in the observation group and the difference showed statistical significance(P <0.0.5).Gonclusion Epidural anesthesia combined with TIVA can effectively protect patients'respiratory function,improve immune function,shorten awakening time and extubation time,promoting postoperative recovery.