硬膜外阻滞复合全身麻醉应用于老年上腹部手术患者的效果及对呼吸功能和免疫抑制程度的影响  

The effect of epidural block combined with general anesthesia in elderly patients undergoing upper abdominal surgery and its influence on respiratory function and immunosuppression

作　　者：谢学珍 Xie Xuezhen(Department of Anesthesiology,Traditional Chinese Medicine Hospital of Guangning County,Zhaoqing City,Guangdong Zhaoqing 526300)

机构地区：[1]肇庆市广宁县中医院麻醉科,广东肇庆526300

出　　处：《中国社区医师》2021年第23期62-63,共2页Chinese Community Doctors

摘　　要：目的:探讨硬膜外阻滞复合全身麻醉应用于老年上腹部手术患者的效果及对呼吸功能和免疫抑制程度的影响。方法:选取2018年5月-2019年5月老年上腹部手术患者52例,随机分为两组,各26例。对照组术前给予全身麻醉;观察组术前给予硬膜外阻滞复合全身麻醉。比较两组临床效果。结果:观察组苏醒时间、定向力恢复时间和拔管时间均明显低于对照组,差异有统计学意义(P<0.05);观察组术后24h用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、每分钟最大通气量(MVV)等呼吸功能指标水平均高于对照组,差异有统计学意义(P<0.05);观察组术后3d中性粒细胞、淋巴细胞、CD4^(+)/CD8^(+)等免疫功能指标水平均高于对照组,差异有统计学意义(P<0.05)。结论:硬膜外阻滞复合全身麻醉用于老年上腹部手术患者,具有良好的临床效果,明显改善了患者的呼吸功能,降低免疫功能受到抑制的程度。Objective:To investigate the effect of epidural block combined with general anesthesia in elderly patients undergoing upper abdominal surgery and its influence on respiratory function and immunosuppression.Methods:From May 2018 to May 2019,52 elderly patients undergoing upper abdominal surgery were selected,they were randomly divided into the two groups with 26 cases in each group.The control group was given general anesthesia before operation.The observation group was given epidural block combined general anesthesia before operation.We compared the clinical effects of the two groups.Results:The recovery time,orientation recovery time and extubation time of the observation group were significantly lower than the control group,the difference was statistically significant(P<0.05).The levels of FVC,FEV1,MVV and other respiratory function indicators in the observation group at 24 h after surgery were higher than the control group,the difference was statistically significant(P<0.05).The levels of immune function indexes such as neutrophils,lymphocytes,CD4^(+)/CD8^(+)in the observation group were higher than those in the control group at 3 days after operation,the difference was statistically significant(P<0.05).Conclusion:Epidural anesthesia combined with general anesthesia for elderly patients undergoing upper abdominal surgery has a good clinical effect,which significantly improving the patient's respiratory function and reducing the degree of suppression of immune function.

关 键 词：硬膜外阻滞 全麻 老年上腹部手术 呼吸功能 免疫抑制 

分 类 号：R614[医药卫生—麻醉学]