氧化亚氮吸入镇痛对肛肠科手术患者炎性因子应激、焦虑抑郁和生活质量的影响

Effects of nitrous oxide inhalation analgesia on inflammatory stress response,anxiety,depression and life quality in patients undergoing anorectal surgery

目的观察氧化亚氮吸入镇痛对肛肠科手术患者炎性因子应激、焦虑抑郁和生活质量的影响。方法我院接受手术治疗的肛肠疾病80例患者随机分为对照组和试验组,每组40例。对照组给予局部注射1%利多卡因,试验组给予氧化亚氮吸入联合局部麻醉。比较2组术前、术后应激激素[肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)]、焦虑抑郁、炎性因子[超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]、细胞免疫功能[T淋巴细胞亚群(CD4^+、CD4^+/CD8^+)、NK细胞]、体液免疫功能[免疫球蛋白(IgA、IgG、IgM)]及生活质量变化。结果2组术前E、NE、Cor、SAS评分、SDS评分、hs-CRP、TNF-α、CD4^+、CD4^+/CD8^+、NK、IgA、IgG、IgM、SF-36生活质量评分比较差异无统计学意义(P>0.05)。2组术后E、NE、Cor、hs-CRP、TNF-α、SF-36生活质量评分均显著高于术前,SAS评分、SDS评分、CD4^+、CD4^+/CD8^+、NK、IgA、IgG、IgM均显著低于术前(P<0.05),且试验组术后E、NE、Cor、SAS评分、SDS评分、hs-CRP、TNF-α低于对照组,CD4^+、CD4^+/CD8^+、NK、IgA、IgG、IgM、SF-36生活质量评分高于对照组,差异均有统计学意义(P<0.05)。结论氧化亚氮吸入镇痛能够有效抑制肛肠科手术患者炎性应激,改善焦虑抑郁状态和生活质量。

Objective To investigate the effects of nitrous oxide inhalation analgesia on inflammatory stress response,anxiety,depression and life quality in patients undergoing anorectal surgery.Methods A total of 80 patients with anorectal diseases who were treated by surgery in our hospital from September 2018 to September 2019 were enrolled in the study,who were randomly divided into control group(n=40)and experimental group(n=40).The patients in control group were given 1%lidocaine by intravenous injection for local anesthesia,however,the patients in experimental group were given nitrous oxide inhalation before anesthesia induction.The stress hormones including E,NE and Cor,and the anxiety,depression,inflammatory cytokines(hs-CRP and TNF-α),cellular immune function indexes(CD4^+,CD4^+/CD8^+and NK),humoral immune function indexes(IgA,IgG and IgM)and life quality before and after operation were observed and compared between the two groups.Results Before surgery there were no significant differences in the levels of E,NE,Cor,SAS scores,SDS scores,hs-CRP,TNF-α,CD4^+,CD4^+/CD8^+,NK,IgA,IgG,IgM and SF-36 life quality scores between the two groups(P>0.05).After surgery,the levels of E,NE,Cor,hs-CRP,TNF-αand SF-36 life quality scores were significantly increased in both groups,however,the SAS scores,SDS scores,the levels of CD4^+,CD4^+/CD8^+,NK,IgA,IgG and IgM were significantly decrease in both groups(P<0.05).Moreover the levels of E,NE,Cor,SAS scores,SDS scores,hs-CRP and TNF-αin experimental group were significantly lower than those in control group,but the levels of CD4^+,CD4^+/CD8^+,NK,IgA,IgG,IgM and SF-36 life quality scores in experimental group were significantly higher than those in control group(P<0.05).Conclusion Nitrous oxide inhalation analgesia can effectively inhibit the inflammatory stress response,improve anxiety and depression state and life quality in patients undergoing anorectal surgery.