原发性腹膜后肿瘤切除患儿围手术期不同麻醉深度的效果分析

Retrospective analysis of different anesthesia depth during perioperative period of primary retroperitoneal tumor resection

目的探究原发性腹膜后肿瘤切除患儿围手术期不同麻醉深度的效果。方法将200例原发性腹膜后肿瘤切除术患儿按照不同的麻醉深度分为麻醉A组与麻醉B组,每组100例。麻醉A组患儿脑电双频指数(BIS)值为40~49,麻醉B组BIS值为50~59。比较两组患儿的疼痛评分、手术时间、出血量,分析麻醉前及手术后T淋巴细胞亚群水平,统计两组患儿的不良反应发生情况。结果T0时,两组患儿疼痛评分比较,差异无统计学意义(P﹥0.05);T_(1)、T_(2)时,麻醉A组患儿疼痛评分均明显低于麻醉B组(P﹤0.01)。麻醉A组患儿手术时间明显短于麻醉B组(P﹤0.01),出血量明显低于麻醉B组(P﹤0.01)。麻醉前,两组患儿血清T淋巴细胞亚群水平比较,差异均无统计学意义(P﹥0.05)。手术后,两组患儿CD8^(+)水平均明显高于本组麻醉前(P﹤0.01),CD4^(+)、CD3^(+)水平均明显低于本组麻醉前(P﹤0.01);麻醉A组患儿CD8^(+)水平明显低于麻醉B组(P﹤0.01),CD4^(+)、CD3^(+)水平均明显高于麻醉B组(P﹤0.01)。麻醉A组患儿不良反应总发生率明显低于麻醉B组(P﹤0.01)。结论原发性腹膜后肿瘤切除术患儿围手术期的不同麻醉深度中,BIS值为40~49时能够较好地缓解患儿的疼痛情况,对术后患儿影响较轻。

Objective To investigate the effect of different anesthesia depths during the perioperative period of prima-ry retroperitoneal tumor resection.Method A total of 200 patients who underwent primary retroperitoneal tumor resec-tion were divided into anesthesia group A and anesthesia group B,100 patients in each group.Bispectral index(BIS)val-ues were 40-49 in the anesthesia A and 50-59 in the anesthesia B.The pain scores,time of surgery,and the amount of bleeding of two groups were compared,the level of T lymphocyte subsets before and after anaesthesia was analyzed,the adverse reactions of the two groups were counted.Result At T0,there was no significant difference in pain scores be-tween the two groups(P>0.05).At T_(1)and T_(2),pain scores in anaesthesia A group were significantly lower than those in an-aesthesia B group(P<0.01).The operation time of children in anesthesia group A was significantly shorter than that in an-esthesia group B(P<0.01),and the amount of bleeding was significantly lower than that in anesthesia group B(P<0.01).Before anesthesia,there was no significant difference in the level of serum T lymphocyte subsets between the two groups(P>0.05).After operation,the levels of CD8^(+) in the two groups were significantly higher than those before anesthesia(P<0.01),the levels of CD4^(+) and CD3^(+) were significantly lower than those before anesthesia(P<0.01);the levels of CD8^(+) in group A were significantly lower than those in group B(P<0.01),the levels of CD4^(+) and CD3^(+) were significantly higher than those in group B(P<0.01).The total incidence of adverse reactions in group A was significantly lower than that in group B(P<0.01).Conclusion Among the different anesthesia depths in the perioperative period of children with prima-ry retroperitoneal tumor resection,BIS value of 40-49 can better alleviate the pain of children,improve the prognosis of children,and have less impact on postoperative children.