七氟烷+丙泊酚全麻对腹腔镜腹股沟疝修补术患者免疫功能与认知功能的影响  

Effects of sevoflurane+propofol general anesthesia on immune function and cognitive function in patients with laparoscopic inguinal hernia repair

作　　者：徐艳 华豪 XU Yan;HUA Hao(Department of Anesthesiology,Wuxi Ninth People's Hospital Affiliated to Soochow University,Wuxi 214000,China)

机构地区：[1]苏州大学附属无锡市第九人民医院麻醉科,无锡214000

出　　处：《中国免疫学杂志》2025年第2期408-412,共5页Chinese Journal of Immunology

摘　　要：目的:探讨七氟烷复合丙泊酚全麻对腹腔镜腹股沟疝修补术患者免疫功能与认知功能的影响。方法:将2021年1月至2022年3月在苏州大学附属无锡市第九人民医院收治的120例腹腔镜腹股沟疝修补术患者随机分成对照组和观察组,均于全麻下进行手术,对照组予以丙泊酚静脉泵入,观察组予以七氟烷复合吸入^(+)丙泊酚静脉泵入。观察两组的生命体征(平均动脉压、心率)、术后疼痛(VAS评分)、免疫功能[T细胞亚群(CD3^(+)T、CD4^(+)T、CD8^(+)T、CD4^(+)T/CD8^(+)T)、IgG、IgA、IgM]、认知功能(MMSE评分、认知功能障碍发生率)以及不良反应(恶心呕吐、头晕、嗜睡、呼吸抑制、体动)。结果:两组置入喉罩后10 min、手术开始时、拔除喉罩后10 min的平均动脉压均低于本组麻醉诱导前(P<0.05),对照组手术开始时的心率低于本组麻醉诱导前(P<0.05),两组各时间段的平均动脉压与心率相近(P>0.05);观察组术后各时间段的VAS评分低于对照组(P<0.05);观察组术后1 d的CD3^(+)T、CD4^(+)T、CD4^(+)T/CD8^(+)T、IgG、IgA、IgM高于对照组(P<0.05),CD8^(+)T低于对照组(P<0.05);两组术后1 d的MMSE评分与认知功能障碍发生率相近(P>0.05);两组不良反应发生率相近(P>0.05)。结论:七氟烷复合丙泊酚全麻在腹腔镜腹股沟疝修补术中的应用效果较好,能够稳定患者术中生命体征,减轻术后疼痛,改善免疫功能指标,且不增加术后认知功能障碍与不良反应的发生率。Objective:To investigate the effect of sevoflurane combined with propofol general anesthesia on immune function and cognitive function in patients undergoing laparoscopic inguinal hernia repair.Methods:A total of 120 patients with laparoscopic inguinal hernia repair treated in Wuxi Ninth People's Hospital Affiliated to Soochow University from January 2021 to March 2022 were randomly divided into control group and observation group.They were operated under general anesthesia.Control group were given propofol intravenous pump,and observation group were given sevoflurane combined inhalation+propofol intravenous pump.The vital signs(mean arterial pressure,heart rate),postoperative pain(VAS score),immune function[T cell subsets(CD3^(+)T,CD4^(+)T,CD8^(+)T,CD4^(+)T/CD8^(+)T),IgG,IgA,IgM],cognitive function(MMSE score,incidence of cognitive impairment)and adverse reactions(nausea and vomiting,dizziness,drowsiness,respiratory depression and body movement)were observed.Results:The mean arterial pressure at 10 min after laryngeal mask implantation,at the beginning of operation and 10 min after laryngeal mask removal in the two groups were lower than that before anesthesia induction(P<0.05),the heart rate at the beginning of operation in the control group was lower than that before anesthesia induction(P<0.05),and the mean arterial pressure and heart rate in each time period in the two groups were similar(P>0.05);the VAS scores of the observation group were lower than those of the control group(P<0.05);The levels of CD3^(+)T,CD4^(+)T,CD4^(+)T/CD8^(+)T,IgG,IgA,IgM in the observation group were higher than those in the control group(P<0.05),and CD8^(+)T was lower than those in the control group 1 day after operation(P<0.05);the MMSE score and the incidence of cognitive impairment were similar in the two groups 1 day after operation(P>0.05);the incidence of adverse reactions in the two groups were similar(P>0.05).Conclusion:Sevoflurane combined with propofol general anesthesia has a good effect in laparoscopic inguinal hernia r

关 键 词：七氟烷 丙泊酚 全麻 腹腔镜腹股沟疝修补术 免疫功能 认知功能 

分 类 号：R614.2[医药卫生—麻醉学]