全身麻醉复合硬膜外阻滞对妇科盆腔手术患者镇痛效果及免疫功能的影响  

Influences of general anesthesia combined with epidural block on analgesic effect and immune function in patients undergoing gynecological pelvic surgery

作　　者：李延 王娜 贾亮 鲁瑶 LI Yan;WANG Na;JIA Liang;LU Yao(Anesthesiology Department,Northwest Women's and Children's Hospital,Xi'an 710061;No.1 Obstetrics Department,Xi'an 521 Hospital of Norinco Group,Xi'an 710065;No.2 Gynecology Department,Northwest Women's and Children's Hospital,Xi'an 710061,China)

机构地区：[1]西北妇女儿童医院麻醉科,陕西西安710061 [2]西安兵器工业五二一医院产一科,陕西西安710065 [3]西北妇女儿童医院妇二科,陕西西安710061

出　　处：《临床医学研究与实践》2023年第13期22-25,共4页Clinical Research and Practice

基　　金：陕西省卫生健康科研基金项目(No.2018D039)。

摘　　要：目的研究全身麻醉复合硬膜外阻滞对妇科盆腔手术患者镇痛效果及免疫功能的影响。方法选取2019年10月至2021年10月我院收治的68例妇科盆腔手术患者,按麻醉方法不同将其分为对照组(34例,全身麻醉)与试验组(34例,全身麻醉复合硬膜外阻滞)。比较两组的麻醉效果。结果术后24 h,试验组的白细胞分化抗原4阳性(CD4^(+))、白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4^(+)/CD8^(+))高于对照组,白细胞分化抗原8阳性(CD8^(+))低于对照组(P<0.05)。术后12 h,试验组的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。术后1、2、3 d,试验组静息状态及咳嗽状态下的视觉模拟评分法(VAS)评分低于对照组(P<0.05)。试验组的内脏牵拉痛分级总体优于对照组(P<0.05)。试验组的肌松度分级总体优于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论全身麻醉复合硬膜外阻滞在妇科盆腔手术患者中的镇痛效果良好,有利于减轻炎症反应。Objective To study the influences of general anesthesia combined with epidural block on analgesic effect and immune function in patients undergoing gynecological pelvic surgery.Methods A total of 68 patients undergoing gynecological pelvic surgery admitted in our hospital from October 2019 to October 2021 were selected and divided into control group(34 cases,general anesthesia)and experimental group(34 cases,general anesthesia combined with epidural block)according to different anesthesia methods.The anesthetic effects of the two groups were compared.Results At 24 h after operation,the cluster of differentiation 4 positive(CD4^(+)),cluster of differentiation 4 positive/cluster of differentiation 8 positive(CD4^(+)/CD8^(+))in the experimental group were higher than those in the control group,the cluster of differentiation 8 positive(CD8^(+))was lower than that in the control group(P<0.05).At 12 h after operation,the levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the experimental group were lower than those in the control group(P<0.05).On the 1,2,3 d after operation,the Visual Analogue Scale(VAS)score in the resting state and cough state of the experimental group was lower than that of the control group(P<0.05).The visceral traction pain grading of the experimental group was better than that of the control group(P<0.05).The muscle relaxation grading of the experimental group was better than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion General anesthesia combined with epidural block has good analgesic effect in patients undergoing gynecological pelvic surgery,which is conducive to reducing inflammatory response.

关 键 词：全身麻醉 硬膜外阻滞 妇科盆腔手术 镇痛 免疫功能 

分 类 号：R737.9[医药卫生—肿瘤]