腰硬联合麻醉用于阑尾炎手术的麻醉效果及对患者免疫功能的影响  

The effect of combined spinal epidural anesthesia on the operation of appendicitis and its effect on the immune function of patients

作　　者：符兴府 纪怀珠[2] 林云雁[2] 王少勤 许绩步 Fu Xing-fu;Ji Huai-zhu.;Lin Yun-yan;Wang Shao-qin;Xu Ji-bu(Department of Anesthesiology,Lingao People's Hospital,lingao 571800,China;Department of Anesthesiology,Hainan Provincial People's Hospital,Haikou 570311,China)

机构地区：[1]临高县人民医院麻醉科,临高571800 [2]海南省人民医院麻醉科,海口570311

出　　处：《湖南师范大学学报（医学版）》2019年第5期187-190,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:分析腰硬联合麻醉用于阑尾炎手术的麻醉效果及对患者免疫功能的影响.方法:选取在我院(2016年10月~2018年3月)进行阑尾炎手术患者108例,根据麻醉方法不同分为对照组和观察组.对照组患者采用硬膜外麻醉,观察组患者采用腰硬联合麻醉,分析两组患者麻醉后的效果.结果:观察组患者感觉阻滞时间、术后排气时间、住院时间短于对照组,差异有统计学意义.麻醉前,两组患者血压、心率水平比较,差异无统计学意义.麻醉后,血压水平优于对照组,HR水平与对照组比较,差异无统计学意义.牵拉阑尾时,观察组患者血压、心率水平优于对照组,差异有统计学意义.术前,两组患者免疫功能指标水平比较,差异无统计学意义.术后24h、72h后,观察组患者CD3+、CD4+、CD8+水平与对照组比较,差异无统计学意义.结论:腰硬联合麻醉用于阑尾炎手术麻醉效果优于硬膜外麻醉,可加快感觉阻滞时间,对免疫功能影响小.Objective To analyze the anesthetic effect of combined spinal-epidural anesthesia for appendicitis operation and its influence on the immune function of patients. Methods 108 patients undergoing appendicitis operation in our hospital (October 2016 to March 2018) were divided into control group and observation group according to different anesthetic methods. The patients in the control group were treated with epidural anesthesia, and the patients in the observation group were treated with combined spinal-epidural anesthesia. Results The sensory block time, postoperative exhaust time and hospitalization time in the observation group were shorter than those in the control group. Before anesthesia, there was no significant difference in blood pressure and heart rate between the two groups. After anesthesia, the blood pressure level was better than that of the control group. The blood pressure and heart rate in the observation group were significantly higher than those in the control group. There was no significant difference in the level of immune function between the two groups before operation. After 24 hours and 72 hours after operation, there was no significant difference between the observation group and the control group in the level of CD3, CD 4, CD 8. Conclusion Combined spinal-epidural anesthesia is better than epidural anesthesia in appendicitis surgery, it can accelerate the time of sensory block and has little effect on immune function.

关 键 词：腰硬联合麻醉 阑尾炎 硬膜外麻醉 血压 免疫功能 

分 类 号：R614[医药卫生—麻醉学]