瑞芬太尼复合丙泊酚对老年子宫切除手术患者免疫功能、血流动力学及应激反应的影响

发布时间：2018-06-16 22:19

本文选题：瑞芬太尼 + 丙泊酚　；参考：《中国老年学杂志》2017年03期

【摘要】：目的探讨瑞芬太尼复合丙泊酚对老年子宫切除手术患者免疫功能、血流动力学及应激反应的影响。方法选取该院收治的160例子宫切除老年患者,按随机数字表法分为复合组和瑞芬太尼组各80例,瑞芬太尼组患者给予瑞芬太尼麻醉,复合组给予瑞芬太尼复合丙泊酚麻醉,麻醉前1 h、麻醉后1 h以及手术结束后1 h检测免疫功能、血流动力学及应激反应的相关指标情况。结果两组患者麻醉前免疫功能、血流动力学及应激反应相关指标无统计学差异(P0.05);与麻醉前相比,麻醉1 h后两组患者免疫细胞(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)显著降低,且复合组显著高于瑞芬太尼组;应激反应相关因子皮质醇(Cor)、去甲肾上腺素(Ne)、总抗氧化能力(TAC)、过氧化氢酶(CAT),血流动力学指标收缩压(SBP)、舒张压(DBP)、心率(HR)、平均动脉压(MAP)、炎症相关因子肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、丙二醛(MDA)、超氧化物歧化酶(SOD)显著升高,但复合组显著低于瑞芬太尼组;手术结束1 h后,两组患者免疫细胞水平、炎症相关因子水平显著高于麻醉1 h后,且复合组免疫细胞水平显著高于瑞芬太尼组,炎症相关因子水平低于瑞芬太尼组;同时两组患者血流动力学指标、应激反应相关因子水平显著低于麻醉1 h后,但复合组显著低于瑞芬太尼组(P0.05)。结论瑞芬太尼复合丙泊酚对老年子宫切除手术患者的免疫功能、血流动力学及应激反应的影响较小,对手术患者的麻醉具有重要的帮助。
[Abstract]:Objective to investigate the effects of remifentanil combined with propofol on immune function, hemodynamics and stress response in elderly patients undergoing hysterectomy. Methods 160 elderly patients with hysterectomy were randomly divided into the compound group (n = 80) and remifentanil group (n = 80). Remifentanil anesthesia was given to the patients in the remifentanil group, and remifentanil combined with propofol anesthesia was given to the patients in the remifentanil group. The immune function, hemodynamics and stress response were measured 1 hour before anesthesia, 1 hour after anesthesia and 1 hour after operation. Results there was no significant difference in immune function, hemodynamics and stress response between the two groups before anesthesia. The compound group was significantly higher than remifentanil group. Stress response related factors cortisol Corn, norepinephrine Neon, total antioxidant capacity TACX, catalase CATN, hemodynamic indices SBP0, diastolic blood pressure (DBP), heart rate (HRN), mean arterial pressure (map), inflammatory related factor tumor necrosis factor TNF- 伪 (TNF- 伪), TNF- 伪, TNF- 伪, TNF- 伪, TNF- 伪, TNF- 伪, TNF- 伪, TNF- 伪, TNF- 伪, TNF- 伪. Interleukin-6, malondialdehyde (MDAA) and superoxide dismutase (SOD) increased significantly. However, the level of immunocytes and inflammatory related factors in the compound group was significantly higher than that in the remifentanil group at 1 hour after operation, and the level of immune cells in the compound group was significantly higher than that in the remifentanil group. The level of inflammatory related factors was lower than that of remifentanil group, and the hemodynamic index and stress response related factor level in both groups were significantly lower than those in remifentanil group after 1 hour of anesthesia, but the level in compound group was significantly lower than that in remifentanil group (P 0.05). Conclusion remifentanil combined with propofol has little effect on immune function, hemodynamics and stress response in elderly patients undergoing hysterectomy.
【作者单位】：重庆医科大学附属永川医院麻醉科;
【分类号】：R614

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