TCI模式下舒芬太尼对腹腔镜子宫切除术患者免疫功能介质及血栓素A2、前列环素的影响

The Effect of Sufentanil on Immune Function Mediators and Thromboxane A2,Prostacyclin in Patients Undergoing Laparoscopic Hysterectomy

目的探究腹腔镜子宫切除术患者舒芬太尼TCI模式对自身免疫功能介质及血栓素A2(TXA2)、前列环素(PGI2)的影响。方法选取2016年9月至2017年11月期间我院收治的行腹腔镜子宫切除术的95例患者,其中46例接受舒芬太尼间断推注给药进行临床麻醉性镇痛的患者为对照组,49例接受舒芬太尼静脉靶向控制输注给药(TCI模式)的患者为观察组,对比分析不同给药模式下舒芬太尼对腹腔镜子宫切除术患者治疗后CD4^+、CD8^+和CD4^+/CD8^+等免疫功能介质及血清血栓素(TXA2)和前列环素(PGI2)的影响。结果两组患者治疗后CD4+、CD8^+和CD4^+/CD8+等免疫功能介质及血清血栓素(TXA2)和前列环素(PGI2)与治疗前相比差异有显著统计学意义(P<0.05);观察组明显优于对照组(P<0.05)。观察组患者治疗后CD4^+、CD4^+/CD8^+和前列环素(PGI2)较对照组明显升高,而CD8+和血栓素(TXA2)较对照组明显降低。结论静脉靶向控制输注给药(TCI)模式能够有效增强腹腔镜子宫切除术患者的免疫功能,降低患者血清中TXA2 水平,升高PGI2水平,且其临床麻醉性镇痛效果较好并易于调整,能够有效缓解患者术后因免疫功能降低而导致的严重等不良反应。

Objective To investigate the effects of sufentanil TCI mode infusion on autoimmune mediators and thromboxane A2(TXA2)and prostacyclin(PGI2)in patients undergoing laparoscopic hysterectomy.Methods A total of 95 patients who underwent laparoscopic hysterectomy from September 2016 to November 2017 were enrolled.Of these 46 patients who underwent intermittent anesthesia with sufentanil for clinical anesthesia were included in the control group.Forty-nine patients who received sufentanil intravenous targeted infusion(TCI mode)were included in the observation group.The effects of sufentanil on immune function mediators such as CD4^+,CD8^+ and CD4^+/CD8^+ and serum thromboxane(TXA2)and prostacyclin(PGI2)in patients undergoing laparoscopic hysterectomy were compared and compared.Results There was no significant difference in preoperative general data between the two groups(P>0.05).The immunological mediators such as CD4^+,CD8^+ and CD4^+/CD8^+ and serum thromboxane(TXA2)and prostacyclin(PGI2)were significantly different between the two groups(P<0.05).Compared with the control group,the difference was statistically significant(P<0.05).CD4+,CD4+/CD8+ and prostacyclin(PGI2)were significantly higher in the observation group than in the control group,while CD8+ and thromboxane(TXA2)were significantly lower than the control group.Conclusion Intravenous targeted controlled infusion(TCI)mode can effectively enhance the immune function of patients undergoing laparoscopic hysterectomy,reduce the level of TXA2 in patients’ serum,increase the level of PGI2,and its clinical anesthetic analgesia is better and easy to adjust.It can effectively alleviate the serious adverse reactions caused by the reduction of immune function in patients after operation.