盐酸羟考酮复合丙泊酚对老年内镜下逆行胰胆管造影术患者麻醉效果、细胞因子及免疫调节的影响

Effects of oxycodone hydrochloride combined with propofol on anesthetic effect,cytokines and immune regulation in elderly patients undergoing endoscopic retrograde cholangiopancreatography

目的探讨盐酸羟考酮复合丙泊酚对老年内镜下逆行胰胆管造影(ERCP)术患者麻醉效果、细胞因子及免疫调节的影响。方法选取2019年6月至2021年6月我院内镜室收治的94例老年ERCP手术患者为研究对象,根据随机数字表法将其分为对照组和研究组,各47例。对照组接受舒芬太尼复合丙泊酚麻醉,研究组接受盐酸羟考酮复合丙泊酚麻醉。比较两组患者的麻醉相关指标、细胞因子与免疫细胞水平及不良反应发生情况。结果研究组的定向力恢复时间、麻醉苏醒时间短于对照组,术后30 min视觉模拟评分法(VAS)评分低于对照组,丙泊酚用量少于对照组(P<0.05)。术后6 h,研究组的白细胞介素-13(IL-13)、白细胞介素-10(IL-10)水平显著高于对照组,白细胞介素-2(IL-2)、γ-干扰素(IFN-γ)水平显著低于对照组(P<0.05)。术后6 h,研究组的调节性T细胞(Treg)、白细胞分化抗原4阳性(CD4+)、自然杀伤细胞(NK细胞)、B细胞及辅助T细胞(Th)/细胞毒性T淋巴细胞(Tc)均显著高于对照组,白细胞分化抗原8阳性(CD8+)显著低于对照组(P<0.05)。研究组的不良反应总发生率显著低于对照组(P<0.05)。结论盐酸羟考酮复合丙泊酚麻醉应用于老年ERCP手术患者中,可有效减少丙泊酚用量,促进术后麻醉恢复,缓解围术期免疫功能紊乱及炎性刺激,麻醉效果安全可靠,值得临床推广及使用。

Objective To investigate the effects of oxycodone hydrochloride combined with propofol on anesthesia effect,cytokines and immune regulation in elderly patients undergoing endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 94 elderly patients undergoing ERCP who were admitted in the endoscopy department of our hospital from June 2019 to June 2021 were selected as the research objects and divided into control group and study group according to random number table method,with 47 cases in each group.The control group received sufentanil combined with propofol anesthesia,and the study group received oxycodone hydrochloride combined with propofol anesthesia.Anesthesia related indicators,cytokines,immune cell levels and the occurrence of adverse reactions were compared between the two groups.Results The recovery time of directional force and anesthesia recovery time in the study group were shorter than those in the control group,the visual analogue scale(VAS)score at 30 min after surgery was lower than that in the control group,and the dosage of propofol was less than that in the control group(P<0.05).At 6 h after surgery,the levels of interleukin-13(IL-13)and interleukin-10(IL-10)in the study group were significantly higher than those in the control group,while the levels of interleukin-2(IL-2)and interferon-γ(IFN-γ)were significantly lower than those in the control group(P<0.05).At 6 h after surgery,the regulatory T cell(Treg),cluster of differentiation 4 positive(CD4+),natural killer cell(NK cell),B cell and T helper cell(Th)/cytotoxic T lymphocyte(Tc)were significantly higher than those in the control group,while the cluster of differentiation 8 positive(CD8+)was significantly lower than that of the control group(P<0.05).The total incidence of adverse reactions in the study group was significantly lower than that in the control group(P<0.05).Conclusion Oxycodone hydrochloride combined with propofol anesthesia applied in elderly patients undergoing ERCP can effectively reduce the dosage of propofol,promote postoperative anesthesia recovery,alleviate perioperative immune dysfunction and inflammatory stimulation,with safe and reliable anesthesia effect,which is worthy of clinical promotion and use.