黄芪注射液静滴对老年腹部手术患者术后镇痛和免疫功能的影响  

The Influence of Huangqi Injection on Postoperative Analgesia and Immunologic Function of Elderly Patients after Abdominal Surgery

作　　者：戴转云[1] 李有武[1] 涂学云[1] 王峥[1] 李成龙[1] 万仑[1] 詹育成 DAI Zhuan-yun;LI You-wu;TU Xue-yun;WANG Zheng;LI Cheng-long;WAN Lun;ZHAN Yu-cheng(Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou,Guangdong 510095)

机构地区：[1]广东省第二中医院,广东广州510095

出　　处：《按摩与康复医学》2018年第15期35-38,共4页Chinese Manipulation and Rehabilitation Medicine

基　　金：广东省中医药局建设中医药强省科研课题;编号:20152008

摘　　要：目的:探讨黄芪注射液静滴对老年腹部手术患者术后镇痛和免疫功能的影响。方法:将腹部手术患者100例随机分为A组和C组各50例,A组于手术结束前及术后24h、48h给予黄芪注射液20m L+0.9%氯化钠溶液80mL静脉滴注,C组静脉滴注等量0.9%氯化钠溶液,术毕启动静脉自控镇痛(PCIA),记录两组患者术后4、8、12、24、48h的视觉模拟评分(VAS)、镇静(Ramsay)评分,48h吗啡用量、镇痛泵(PCA)按压次数及不良反应,检测患者麻醉前、术毕、术后第1天及3天的T淋巴细胞亚群、NK细胞。结果:与C组比较,A组术后48h VAS评分、镇痛药用量、镇痛泵(PCA)按压次数无显著性差异(P>0.05),Ramsay评分有显著性升高(P<0.05),术后48h吗啡用量和不良反应有显著减少(P<0.05、P<0.01),A组术后第1、3天T淋巴细胞亚群(CD3^+、CD4^+、CD8^+)、NK细胞及CD4^+/CD8^+显著增加(P<0.05);与麻醉前相比,A组和C组术毕、C组术后第1天T淋巴细胞亚群CD3^+、CD4^+、CD8^+、CD4^+/CD8^+及NK细胞均有显著性降低(P<0.05)。结论:黄芪注射液静滴能增强老年腹部手术患者吗啡的镇痛效果、减少吗啡用量及镇痛时的不良反应,改善术后细胞免疫功能。Objective： To investigate the influence of Huangqi injection on postoperative analgesia and immunologic function of elderly patients after abdominal surgery. Methods： 100 cases of elderly patients after abdominal surgery were randomly divided into group A（50 cases） and group C（50 cases）, the group A received intravenous drip with Huangqi injection（20 mL）＋ 0.9% sodium chloride solution（80 mL） before and 24 h, 48 h after surgery while group C with same dose of 0.9% sodium chloride solution, set up patient controlled intravenous analgesia（PCIA） after surgery, and recorded the visual analogue scales（VAS） and Ramsay score in 4 h, 8 h, 12 h, 24 h and 48 h after surgery, 48 h morphine dosage, press times of PCA and complications, and detected the T-lymphocyte subgroup and NK cells before anaesthesia and 0 h, 1 day and 3 days after surgery. Results： Compared with group C, there was no statistical difference in VAS score in 48 h after surgery, dosage of analgesics and press times of PCA（P〈 0.05）, while Ramsay score of group A was significantly increased（P〈 0.05）, 48 h morphine dosage and complications were significantly decreased（P〈 0.05, P〈 0.01）,and T-lymphocyte subgroup（CD3＋, CD4＋, CD8＋）, NK cells and CD4＋/CD8＋were significantly increased（P〈 0.05）; compared with those before anaesthesia, T-lymphocyte subgroup（CD3＋, CD4＋, CD8＋, CD4＋/CD8＋） and NK cells were significantly decreased immediately after surgery in group A and C and 1 day after surgery in group C（P〈 0.05）. Conclusion： Huangqi injection can improve the analgesic effect of morphine in elderly patients after abdominal surgery, reduce their morphine dosage and adverse effects of analgesia, and improve the cellular immune function after surgery.

关 键 词：腹部手术 术后镇痛 黄芪注射液 静脉滴注 免疫功能 老年患者 吗啡 T淋巴细胞 NK细胞 

分 类 号：R656[医药卫生—外科学]