不同麻醉方法对上腹部手术病人免疫球蛋白的影响  

The effect of different anesthesia methods on immunoglobulins during upper abdominal surgery

作　　者：施培青 马正美[1] 邱谷[2] 张晓萍[1] 江恬[1] 

机构地区：[1]江苏省南通市第二人民医院麻醉科,226002 [2]江苏省南通市第二人民医院检验科,226002

出　　处：《临床麻醉学杂志》2001年第10期546-548,共3页Journal of Clinical Anesthesiology

摘　　要：目的　探讨上腹部手术中三种不同麻醉方法对血清免疫球蛋白IgG、IgA和IgM浓度的影响。方法　 30例择期上腹部手术随机分为静脉复合全麻组 (Ⅰ组 ) ,静脉、吸入复合全麻组 (Ⅱ组 )和静脉全麻复合硬膜外阻滞 (Ⅲ组 )。测定麻醉前 (T0 )、手术开始后 6 0分钟 (T1)、术后 2 4小时(T2 )、术后 4 8小时 (T3 )和术后 72小时 (T4)血清中IgG、IgA和IgM的浓度 ,同时连续监测SBP、DBP、MAP和HR的变化。结果　与麻醉前相比 ,Ⅰ、Ⅱ组IgG、IgA和IgM浓度显著升高 (P <0 0 1) ,而Ⅲ组IgG、IgA、IgM浓度显著降低 (P <0 0 1)。术后 2 4小时变化幅度最大 ,术后 2～ 3天接近麻醉前水平。Ⅲ组的IgG、IgA和IgM浓度变化幅度明显小于Ⅰ组 (P <0 0 1)。三组的IgG、IgA、IgM浓度与SBP、DBP、HR均无相关性。结论　静脉全麻复合硬膜外阻滞用于上腹部手术 ,对血清IgG、IgA、IgM浓度的影响最小 。Objective To observe the effect of three different anesthesia methods on the densities of immunoglobulins(IgG,IgA,IgM) during upper abdominal surgery.Methods 30 cases of upper abdominal surgery were randomly divided into three groups:group Ⅰ (intravenous balanced anesthesia),group Ⅱ(intravenous inhalation anesthesia),group Ⅲ(combined intravenous general anesthesia with epidural block).The densities of IgG,IgA and IgM were measured before induction(T 0),at 60min after incision(T 1),24 hours after surgery(T 2),48 hours after surgery(T 3),72 hours after surgery(T 4),and the changes of SBP,DBP,MAP and HR were recorded simultaneously.Results The densities of IgG?IgA and IgM increased obviously in group Ⅰ and group Ⅱ( P< 0 01),but the densities of IgG,IgA and IgM in group Ⅲ decreased with a smaller magnitude obviously( P< 0 01) compored with those before induction.The changes reached to a peak level in 24 hours after surgery and slowly returned to the level before anesthesia with in two to three days thenafter.There was no correlation between the densities of IgG,IgA and IgM and changes of SBP,DBP,MAP and HR.Conclusion Among three different anesthesia methods,combined intravenous general epidural anesthesia has the lest effect on the densities of IgG,IgA and IgM with a quicker postoperative recovery. [

关 键 词：腹部手术 全麻 硬膜外阻滞 免疫球蛋白 

分 类 号：R614.1[医药卫生—麻醉学]