瑞芬太尼联合硬膜外阻滞控制性降压对腹腔镜下妇科肿瘤根治术患者免疫功能影响.docVIP

瑞芬太尼联合硬膜外阻滞控制性降压对腹腔镜下妇科肿瘤根治术患者免疫功能影响 　　【摘要】 目的：研究瑞芬太尼?合硬膜外阻滞控制性降压方式对行腹腔镜下妇科肿瘤根治术患者免疫功能的影响。方法：选取笔者所在医院于2015年11月-2016年8月收治的76例择期行腹腔镜下妇科肿瘤根治术患者为研究对象，按就诊编号分为两组，单号纳入对照组（n=38），双号纳入研究组（n=38）。对照组采用常规麻醉，研究组采用瑞芬太尼联合硬膜外阻滞控制性降压。比较两组术野清晰度、术中出血量、尿素氮（BUN）、血肌酐（Scr）及免疫功能（CD4+、CD8+ T淋巴亚群比率，血清IgG、IgA、IgM免疫球蛋白含量）变化。结果：研究组Fromme分值低于对照组、术中出血量少于对照组，差异有统计学意义（P0.05）；对照组、研究组各个时间点的BUN、Scr与术前1 d比较，差异无统计学意义（P0.05）。手术后CD3+、CD4+、CD8+明显改变，且对照组变化幅度显著大于研究组，差异有统计学意义（P0.05），研究组IgG、IgA和IgM含量明显高于对照组，差异有统计学意义（P0.05）。结论：行腹腔镜妇科肿瘤根治术患者给予瑞芬太尼复合硬膜外阻滞控制性降压方式，可显著减少术中出血量，提高术野清晰度，且对患者免疫功能无明显影响，优势显著，具有临床推广意义。 　　【关键词】 瑞芬太尼； 控制性降压； 妇科肿瘤根治术； 免疫功能 　　doi：10.14033/ki.cfmr.2017.32.001 文献标识码 A 文章编号 1674-6805（2017）32-0001-04 　　Effects of Remifentanil Combined with Epidural Anesthesia in Controlled Hypotension on Immune Function in Patients with Laparoscopic Gynecologic Oncology Radical Operation/JIA Junxiang，YAO Xiangguo，LI Bing，et al.//Chinese and Foreign Medical Research，2017，15（32）：1-4 　　【Abstract】 Objective：To study the effects of Remifentanil combined with epidural anesthesia in controlled hypotension on immune function in patients with laparoscopic gynecologic oncology radical operation.Method：76 patients with laparoscopic gynecologic oncology radical operation in our hospital from November 2015 to August 2016 were selected as the research object，and they were divided into two groups by registration order.The odd numbers were included into control group（n=38），and the even numbers were included into research group（n=38）.Control group was given routine anesthesia，while research group was given controlled hypotension with Remifentanil combined with epidural anesthesia.The surgical field clarity，intraoperative bleeding volume，blood urea nitrogen（BUN），serum creatinine （Scr），immune function （ratio of CD4+，CD8+，T-lymphocyte subsets，content of serum IgG，IgA，IgM） were compared between the two groups.Result：The Fromme score in research group was lower than that in control group and the intraoperative bleeding volume was