Effect of different anesthesia methods on immune function in patients of laparoscopic cholecystectomy in peri-operative period  

不同麻醉方法对腹腔镜胆囊切除术患者围术期免疫功能的影响(英文)

作　　者：顾陈怿[1] 沈利荣[2] 丁依红[1] 楼怡[1] 吴焕淦[2] 施征[2] 马晓芃[2] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院麻醉科 [2]上海市针灸经络研究所

出　　处：《World Journal of Acupuncture-Moxibustion》2011年第3期35-40,共6页世界针灸杂志（英文版）

基　　金：Supported by National Natural Scientif ic Foundation: 30772832

摘　　要：Objective To compare effects of combined acupuncture and general anesthesia （CAGA） and general anesthesia （GA） on immune function in patients of laparoscopic cholecystectomy （LC） in peri-operative period. Methods Thirty-nine cases undergoing LC were randomly divided into a CAGA group and a GA group. The CAGA group was treated with electroacupuncture at Hegu （合谷- LI 4）, Neiguan （内关PC 6）, Zusanli （足三里ST 36） and Yanglingquan （阳陵泉 GB 34） for 15-30 minutes followed by the general anesthesia, and the continuous electroacupuncture stimulation was given till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subsets, tumor necrosis factor-alpha （TNF-α） and interleukin-6 （IL-6） were observed before anesthesia induction, and 2 hours, 1st and 3 rd day after operation, and the adverse reaction after operation was recorded. Results At 2 hours after operation, the percentages of CD3 and CDs in both groups were significantly lower than those before anesthesia induction （all P〈0.05）, and the percentage of CD4 in the GA group decreased significantly （P〈0.05）, while the percentage of CD： did not significantly change and CD4/CD8 increased significantly in the CAGA group （P〈0.05）. At 3 days after operation, the level of TNF-α in the ACGA group decreased significantly as compared with that before anesthesia induction （P〈0.05）. The cases with nausea after operation in the CAGA group were significantly less than those in the GA group （P〈0.05）. Conclusion Acupuncture combined with general anesthesia has a little effect on immune function in patients of LC with less adverse reactions.目的:比较针药复合麻醉和全身麻醉和对腹腔镜胆囊切除术(LC)患者围术期免疫功能影响的差异。方法:选取择期行LC患者39例,随机分成针药复合麻醉组(针药组)和全麻组。针药组先行电针刺激1～30 min,穴取合谷、内关、足三里、阳陵泉,然后行全身麻醉,电针刺激至手术结束;全麻组单纯行全身麻醉。分别观察两组患者麻醉诱导前、术后2 h、术后第1、3天T淋巴细胞亚群、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的变化及术后不良反应的发生情况。结果:术后2 h两组总T淋巴细胞(CD+3)、抑制T淋巴细胞(CD+8)较麻醉诱导前降低(均P<0.05);全麻组辅助T淋巴细胞(CD+4)显著降低(P<0.05),针药组CD+4无显著改变,CD+4 /CD+8显著上升(P<0.05)。术后第3天针麻组TNF-α与麻醉诱导前比较显著降低(P<0.05)。针麻组患者术后恶心例数明显少于全麻组(P<0.05)。结论:针药复合麻醉对LC患者免疫功能影响较小,术后不良反应发生低。

关 键 词：Combined Acup Medic Anesthesia LAPAROSCOPES CHOLECYSTECTOMY T-Lymphocyte Subsets Tumor Necrosis Factor-alpha INTERLEUKIN-6 

分 类 号：R614[医药卫生—麻醉学]