不同复合全麻策略对腹腔镜子宫切除术患者的临床效果及对血清CRP、BNP、B细胞及NK细胞的影响  

Clinical effects of different combined general anesthesia strategies on patients undergoing laparoscopic hysterectomy and their effects on serum CRP,BNP,B cells and NK cells

作　　者：张佳佳 吴凤琴[1] 丁露 麻贺 王娟 包明胜 ZHANG Jiajia;WU Fengqin;DING Lu;MA He;WANG Juan;BAO Mingsheng(Department of Anesthesiology,Chizhou Second People's Hospital,Chizhou,Anhui,China,247000;Department of Anesthesiology,the People's Hospital of Chizhou,Chizhou,Anhui,China,247000)

机构地区：[1]池州市第二人民医院麻醉科,安徽池州247000 [2]池州市人民医院麻醉科,安徽池州247000

出　　处：《分子诊断与治疗杂志》2025年第1期79-82,87,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省教育厅科研项目(2024AH051881)。

摘　　要：目的比较不同复合全麻策略对腹腔镜子宫切除术患者的临床效果及对血清CRP、BNP、B细胞及NK细胞的影响。方法选取2021年7月至2023年11月池州市第二人民医院收治的122例行腹腔镜子宫切除术患者为观察对象,采用抽样便利法将其分为A组(硬膜外阻滞复合全麻)、B组(静脉复合吸入全麻),各61例。比较两组麻醉相关指标(麻醉时长、恢复自主呼吸时长、术后完全清醒时间、拔管时长、术后住院时长)、疼痛情况、生命体征(MAP及心率)、血清CRP及BNP、B细胞及NK细胞及不良反应总发生率。结果A组麻醉时长长于B组,恢复自主呼吸时长、术后完全清醒时间、拔管时长、术后住院时长均短于B组,差异有统计学意义(P<0.05)。术后6 h、12 h、24 h、48 h,两组VAS评分均降低,且术后12 h、24 h、48 h A组VAS评分均显著低于B组,差异有统计学意义(P<0.05)。A组气腹后MAP高于B组,气腹后、术毕心率低于B组,差异有统计学意义(P<0.05)。较麻醉前,两组术后1 d、术后3 d血清CRP、BNP水平均出现上升,但A组术后1 d、术后3 d上述指标水平显著低于B组,差异有统计学意义(P<0.05)。较术前,两组术后30 min B细胞及NK细胞均升高,但A组术后30 min NK细胞低于B组,差异有统计学意义(P<0.05);两组术前、术后30 min B细胞比较,差异无统计学意义(P>0.05)。结论腹腔镜子宫切除术中,硬膜外阻滞复合全麻在镇痛、生命体征、抗炎护心、免疫及安全性等方面均优于静脉复合吸入全麻,可为麻醉策略选择提供有力依据。Objective To compare the clinical effects of different combined general anesthesia strategies on patients undergoing laparoscopic hysterectomy and their effects on serum CRP,BNP,B cells,and NK cells.Methods A total of 122 patients undergoing laparoscopic hysterectomy at the Second People's Hospital of Chizhou from July 2021 to November 2023 were selected for the observation subjects.They were di⁃vided into two groups:Group A(epidural block combined with general anesthesia)and Group B(intravenous combined with inhalation general anesthesia)by sampling convenience method,with 61 cases in each group.Anesthesia⁃related indicators,including anesthesia duration,recovery of spontaneous breathing duration,postoperative complete awake time,extubation duration,postoperative hospital stay,painlevels,vital signs(MAP and heart rate),serum CRP and BNP levels,B cells and NK cells and the total incidence of adverse reactions were compared between the two groups.Results The duration of anesthesia in group A was longer than that in group B,and the duration of spontaneous breathing recovery,postoperative full awake time,extubation time and postoperative hospitalization time were shorter than those in group B,the differences were statistically sig⁃nificant(P<0.05).At 6 h,12 h,24 h and 48 h after the operation,the VAS scores of the two groups decreased,and the VAS scores of group A at 12 h,24 h and 48 h after the operation were significantly lower than those of group B,and the differences were statistically significant(P<0.05).The MAP after pneumoperitoneum in group A was higher than that in group B,and the heart rate after pneumoperitoneum and after the operation was lower than that in group B,the differences were statistically significant(P<0.05).Compared with before anesthesia,the levels of serum CRP and BNP in the two groups increased at 1 d and 3 d after the operation.However,the levels of the above indexes in group A were significantly lower than those in group B at 1 d and 3 d after the operation,and the differences were

关 键 词：腹腔镜子宫切除术 复合全麻策略 CRP BNP B细胞 NK细胞 

分 类 号：R614[医药卫生—麻醉学]