HIV感染手术患者不同麻醉方式的并发症影响分析

Impact of different anesthesia methods on complications in HIV infection patients

目的探讨分析不同麻醉方式对人类免疫缺陷病毒(HIV)感染患者麻醉并发症的影响,为其手术选择适宜的麻醉方式。方法选取2009年6月-2014年6月于医院行手术治疗的78例HIV感染患者,随机将其分为两组,每组各39例,对照组患者行单纯硬膜外麻醉,观察组患者行腰硬联合麻醉,比较两组患者的麻醉效果、不良反应以及T细胞亚群数量变化。结果观察组的患者麻醉起效时间、完善时间分别为(0.82±0.20)、(7.36±1.28)min,对照组分别为(4.33±1.24)、(14.05±2.44)min,观察组低于对照组,两组比较差异有统计学意义;观察组患者麻醉效果优良率100.0%,对照组为92.3%,两组比较差异无统计学意义;观察组患者与对照组的麻醉并发症、术后并发症的发生率与T淋巴细胞亚群变化差异无统计学意义。结论单纯硬膜外麻醉、腰硬联合麻醉效果良好,安全性高,对免疫功能抑制较轻,均可用于HIV感染者的手术,单纯硬膜外麻醉的麻醉并发症、术后并发症的发生率相对较低,但并无明显差异,腰硬联合麻醉起效快,麻醉完善用时短,更具优势。

OBJECTIVE To explore the impact of different anesthesia methods on anesthesia-induced complications in patients with human immunodeficiency virus（HIV）infections so as to choose appropriate anesthesia method for the HIV infection patients.METHODS A total of 78 patients with HIV infections who underwent surgery in the hospital from Jun 2009 to Jun 2014 were enrolled in the study and randomly divided into two groups,with 39 cases in each;the control group was treated with simple epidural anesthesia,while the observation group was given the combined spinal-epidural anesthesia;the effect of anesthesia,incidence of adverse reactions,and change of T cell subsets counts were observed and compared between the two groups.RESULTS The onset time of anesthesia of the observation group was（0.82±0.20）min,shorter than（4.33±1.24）min of the control group;the improvement time of anesthesia of the observation group was（7.36±1.28）min,shorter than（14.05±2.44）min of the control group,there was significant difference between the two groups.The rate of excellent and good anesthesia effect was 100.0%in the observation group,92.3%in the control group,there was no significant difference between the two groups.There was no significant difference in the incidence of anesthesia-induced complications,the incidence of postoperative complications,or the change of T cell subsets counts between the observation group and the control group.CONCLUSION The simple epidural anesthesia and the combined spinal-epidural anesthesia can achieve good effect and slightly inhibit the immune function,with the safety high;both can be applied for the surgery of the HIV infection patients.The incidence of the anesthesia-induced complications and the postoperative complications is relatively low when the simple epidural anesthesia is applied,without significant difference;while the onset of the combined spinal-epidural anesthesia is quicker,the improvement time of anesthesia is shorter,and the advantage is more significant.