两种麻醉方法在小儿斜疝手术中对特异性细胞免疫功能的作用.pdfVIP

两种麻醉方法 在小儿斜疝手术中对特异性细胞免疫功能的影响 摘 要 目的：研究七氟醚吸入喉罩全麻和骶管阻滞复合七氟醚吸入喉罩全麻对小儿 斜疝患者围术期机体特异性细胞免疫的影响。 方法：40 例择期行疝囊高位结扎术的小儿患者随机分为2 组：七氟醚吸入喉 罩全麻组（A 组）、骶管阻滞复合七氟醚吸入喉罩全麻组（B 组）。分别于麻醉 前、术后2h 、术后1d、术后3d 抽取外周静脉血，采用流式细胞术（Flow CytoMeter, FCM ）监测外周血T 淋巴细胞亚群的变化。 结果：术后2h ，两组CD3+ + + + 、CD4 、CD4 /CD8 比值均下降，与麻醉前比较， 七氟醚吸入喉罩全麻组下降明显（P0.05 ），骶管阻滞复合七氟醚吸入喉罩全麻组 + + + + + 下降不明显（P0.05 ），CD8 变化不明显；术后1d，两组CD3 、CD4 、CD4 /CD8 + + + + 比值均明显下降，但前者CD3 、CD4 、CD4 /CD8 比值降低幅度均明显高于后者 （与麻醉前比较，P0.05 ；组间比较，P0.05 ）。 结论：七氟醚吸入喉罩全麻和骶管阻滞复合七氟醚吸入喉罩全麻均可抑制小 儿特异性细胞免疫功能，但后者对小儿特异性细胞免疫功能的影响较小。 关键词：七氟醚 喉罩全麻 骶管阻滞 小儿 特异性细胞免疫 2 The Reflection of Two Kinds of Anesthesia on Perioperative Specific Cellular Immunity of Pediatric Indirect Inguinal Hernia . Abstract Objectives: To compare the reflection of sevoflurane for laryngeal mask anesthesia and caudal block combined with sevoflurane for laryngeal mask anesthesia on perioperative specific cellular immunity of pediatric indirect inguinal hernia. Methods: In this study, 40 children with indirect inguinal hernia were randomized into a control group(Group A), who were treated by sevoflurane for laryngeal mask anesthesia ，and an experimental group(Group B), who were engaged in the treatment of caudal block combined with sevoflurane for laryngeal mask anesthesia. The blood of peripheral vein was drew before anesthesia, 2h, 1d, and 3d after the end of the operation. The change of T lymphocyte subset was detected by Flow CytoMeter.