盐酸羟考酮注射液复合丙泊酚麻醉用于老年患者内镜下逆行胰胆管造影术的血流动力学和机体免疫功能

目的 探讨盐酸羟考酮注射液复合丙泊酚麻醉用于老年患者内镜下逆行胰胆管造影术(ERCP)的血流动力学和机体免疫功能的影响.方法 收集行ERCP的100例老年患者的资料,将所有患者按照随机数字表法分成对照组和观察组,对照组使用芬太尼联合丙泊酚进行ERCP麻醉,观察组使用羟考酮注射液联合丙泊酚进行ERCP麻醉,分析比较两种方法对血流动力学和机体免疫功能的影响.结果 两组患者心率、平均动脉压、呼吸频率和脉搏血氧动脉饱和度等指标,仅部分指标若干时间点的差异有统计学意义(P＜0.05);两组患者麻醉后白细胞介素-10(IL-10)均明显降低(P＜0.05),但观察组高于对照组(P＜0.05);麻醉后干扰素-γ(INF-γ)均升高(P＜0.05),麻醉后观察组INF-γ低于对照组(P＜0.05);两组患者麻醉前的CD4+,CD8+和CD4+/CD8+水平相近,麻醉后CD4+均降低(P＜0.05),但观察组高于对照组(P＜0.05);麻醉后两组患者CD8+均升高(P＜0.05),但观察组低于对照组(P＜0.05);麻醉后两组患者的CD4 +/CD8+均降低(P＜0.05),但观察组高于对照组(P＜0.05).结论 盐酸羟考酮复合丙泊酚用于老年患者的ERCP,血流动力学稳定,能够缓解围手术期的免疫功能紊乱,值得在更大范围内进行临床推广.

Effects of oxycodone hydrochloride injection combined with propofol anesthesia on hemodynamics and immune function in elderly patients undergoing endoscopic retrograde cholangiopancreatography

Objective To investigate the effects of oxycodone hydrochloride injection combined with propofol anesthesia on hemodynamics and immune function in elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).Methods A total of 100 elderly patients with ERCP were enrolled.All patients were assigned into two groups according to the random number method.ERCP anesthesia was conducted with fentanyl combined with propofol in the control group while ERCP anesthesia was conducted with oxycodone combined with propofol in the observation group.The effects of the two methods on hemodynamics and immune function were analyzed and compared.Results There were significant differences in some of the indexes of heart rate,mean arterial pressure,respiratory rate and arterial blood oxygen saturation at some time points between the two groups (P ＜ 0.05).Post-anesthesia IL-10 level were significantly decreased in both groups (P ＜ 0.05),but the observation group higher than the control group (P ＜ 0.05).Post-anesthesia INF-γlevel was significantly increased in both groups (P ＜ 0.05),but the observation group lower than the control group (P ＜ 0.05).Before anesthesia the levels of CD4 +,CD8 + and CD4 +/CD8 + were similar,but after anesthesia CD4 + levels were decreased in both groups (P ＜ 0.05),with the observation group higher than the control group (P ＜ 0.05);CD8 + levels were increased in both groups (P ＜ 0.05),with the observation group lower than the control group (P ＜ 0.05);and CD4 +/CD8 + levels of two groups were both decreased (P ＜ 0.05),with the observation group higher than the control group (P ＜ 0.05).Conclusions Oxycodone hydrochloride conforms to propofol for endoscopic retrograde cholangiopancreatography in elderly patients with hemodynamic stability,which can relieve perioperative immune disorder,and is worthy of clinical application in a wider range.