硬膜外复合全麻与全身麻醉对腹部手术患者血流动力学和免疫功能影响的比较

目的比较硬膜外复合全身麻醉与全身麻醉对腹部手术患者血流动力学和免疫反应的影响。方法 2011年1月—2011年6月择期行腹部手术的80例患者随机分为观察组和对照组,每组各40例。观察组患者接受硬膜外联合全身麻醉,对照组患者接受全身麻醉。常规检测无创血压、心率、脉搏血氧饱和度。分别于麻醉前(T0)、手术结束时(T1)、术后12h(T2)、术后24h(T3)和术后48h(T4)检测CD4+和CD8+。结果 T0时两组收缩压、舒张压、心率和血氧饱和度差异均无统计学意义(P>0.01),T1、T2、T3和T4时两组间比较差异具有统计学意义(P<0.01)。T0时两组CD4+和CD8+差异均无统计学意义(P>0.01),T1、T2、T3和T4时两组CD4+和CD8+差异具有统计学意义(P<0.01)。结论硬膜外复合全身麻醉麻醉对腹部手术患者血流动力学影响较少,并且对患者的免疫功能影响较小。

Effect of caudalanaesthesia combined with general anesthesia and general anesthesia on hemodynamics and Immune function in patients with abdominal surgery

Objective To compare effect of caudalanaesthesia combined with general anesthesia and general anesthesia on haemodynamics and immune function in patients with abdominal surgery.Methods Totally 80 patients underwent abdominal surgery in January 2011-June 2011 were randomly divided into observation group and control group.The patients in observation group received caudalanaesthesia combined with general anesthesia,and the patients in control group received general anesthesia.Invasive blood pressure,heart rate,oxyhemoglobin saturation were measured in routine practice.CD4+ and CD8+ were measured before anesthesia(T0),end of operation(T1),12 hour after operation(T2),24 hour after operation(T3) and 48 hour after operation(T4).Results Blood pressure,heart rate,oxyhemoglobin saturation in both groups at T0 were not significantly different in both groups(P>0.05),but they were significantly different at T1,T2,T3 and T4 in both groups(P<0.01 or P<0.05).CD4+ and CD8+ at T0 were not significantly different in both groups(P>0.01),but they were significantly different at T1,T2,T3 and T4 in both groups(P<0.01).Conclusions Caudalanaesthesia combined with general anesthesia affects the haemodynamics and immune function much less,compared with general anesthesia.