不同麻醉方式对老年腹腔镜手术患者的麻醉效果及对T淋巴细胞亚群和不良反应的影响

Anesthetic effects of different anesthesia methods on elderly patients undergoing laparoscopic surgery and their influences on T lymphocyte subsets and adverse reactions

目的探究不同麻醉方式对老年腹腔镜手术患者的麻醉效果及对T淋巴细胞亚群和不良反应的影响。方法选取2015年1月至2018年12月我院收治的行腹腔镜手术治疗的90例老年患者作为研究对象,根据麻醉方式的不同将其分为A组(31例,全凭静脉麻醉)、B组(30例,硬膜外阻滞复合静脉麻醉)和C组(29例,吸入麻醉)。比较三组的麻醉效果。结果三组的呼吸恢复时间、睁眼时间、拔管(罩)时间和定向力恢复时间比较,差异无统计学意义(P>0.05)。T1、T2时,B组的CD3+、CD4+及CD4+/CD8+高于A组和C组,差异具有统计学意义(P<0.05)。B组的不良反应总发生率低于A组和C组(P<0.05)。结论硬膜外阻滞复合静脉麻醉应用在老年腹腔镜手术中的效果显著,可维持T淋巴细胞亚群稳定,且不良反应少,安全性高,值得推广。

Objective To explore the anesthetic effects of different anesthesia methods on elderly patients undergoing laparoscopic surgery and their influences on T lymphocyte subsets and adverse reactions.Methods A total of 90 elderly patients undergoing laparoscopic surgery admitted in our hospital from January 2015 to December 2018 were selected as the research objects.According to different anesthesia methods,the patients were divided into group A(31 cases,total intravenous anesthesia),group B(30 cases,epidural block combined with intravenous anesthesia)and group C(29 cases,inhalation anesthesia).The anesthetic effects of the three groups were compared.Results There were no significant differences in breathing recovery time,eye opening time,extubation(cover removal)time and orientation recovery time among the three groups(P>0.05).At T1 and T2,the CD3+,CD4+and CD4+/CD8+in the group B were higher than those in the group A and group C,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the group B was lower than that in the groups A and group C,the differences were statistically significant(P<0.05).Conclusion Epidural block combined with intravenous anesthesia applied in elderly laparoscopic surgery has obvious effect,it can maintain the stability of T lymphocyte subsets,has less adverse reactions and high safety,which is worthy of promotion.