腰麻加微量吗啡对剖宫产产妇CRP和IL-2的影响

Influence of Spinal Anesthesia Combined with Micro Morphine on CRP and IL-2 of Puerperas with Cesarean Section

目的探讨腰麻加微量吗啡对剖宫产产妇CRP和IL-2的影响。方法选取2017年7月至2018年7月于我院择期行剖宫产术的120例产妇,随机分为对照组(0.75%布比卡因1.8 m L)和观察组(吗啡0.2 mg+0.75%布比卡因1.8 m L)各60例,于T0、 T1、 T2、 T3测定血清IL-2、 CRP水平,比较两组产妇的VAS评分及不良反应情况。结果观察组术后6 h、 12 h、 48h的VAS评分均明显低于对照组(P <0.05)。T2、 T3时,两组的CRP水平明显高于T0时(P <0.05),但两组的CRP水平比较无统计学差异(P>0.05)。观察组T1时的IL-2水平明显低于T0时(P <0.05), T2时逐渐恢复至正常水平; T1时,两组的IL-2水平比较无统计学差异(P>0.05)。两组均无呼吸抑制现象,观察组有3例面部轻度瘙痒,可耐受。结论剖宫产手术采取腰麻加微量吗啡麻醉,术后镇痛效果良好,安全性好,但具有一过性免疫抑制作用。

Objective To explore the influence of spinal anesthesia combined with micro morphine on CRP and IL-2 of puerperas with cesarean section. Methods 120 cases of puerperas with elective cesarean section in our hospital from July 2017 to July 2018 were selected and randomly divided into control group(0.75% bupivacaine 1.8 m L) and observation group(morphine 0.2 mg + 0.75%bupivacaine 1.8 m L), with 60 cases in each group. The serum IL-2 and CRP levels at T0, T1, T2 and T3 were detected. The VAS scores and adverse reactions were compared between the two groups. Results The VAS scores at 6 h, 12 h and 48 h after surgery of the observation group were significantly lower than those of the control group(P<0.05). At T2 and T3, the CRP levels of the two groups were significantly higher than those at T0(P<0.05), but without statistical difference between the two groups(P>0.05). The IL-2 level at T1 of the observation group was significantly lower than that at T0(P<0.05), and the IL-2 gradually recovered to normal level at T2. No statistical difference was found in the IL-2 level at T1 between the two groups(P>0.05). No respiratory inhibition occurred in both groups, and 3 cases in the observation group had facial mild pruritus, but were tolerated. Conclusions Spinal anesthesia combined with micro morphine has good postoperative analgesic effect and safety in cesarean section, but has transient immunosuppressive effect.