羟考酮对慢性乙型肝炎剖宫产产妇术后T细胞功能的影响

发布时间：2018-07-01 15:39

本文选题：羟考酮 + 剖宫产　；参考：《临床麻醉学杂志》2017年09期

【摘要】：目的探讨羟考酮术后镇痛对慢性乙型肝炎剖宫产产妇术后T细胞功能的影响。方法择期在腰-硬联合麻醉下行剖宫产的慢性乙型肝炎产妇60例,年龄22~35岁,ASAⅠ或Ⅱ级,Child分级A或B,随机分为两组,每组30例。分别采用羟考酮0.8mg/kg(O组)和吗啡0.8mg/kg(M组)行术后静脉镇痛,镇痛泵配方均用生理盐水稀释至100ml,背景量2ml/h,Bolus 2ml,锁定时间15min。记录术毕即刻、术后24、48、72h免疫细胞(Th1、Th2细胞)及生化指标。记录术后24h内镇痛泵的按压次数和累计镇痛药用量。记录术后不良反应情况。结果术后24h和48h,O组Th1明显高于M组(P0.05);M组Th1、Th2细胞变化差异无统计学意义。O组总按压次数和镇痛药累计用量明显少于M组(P0.05)。两组术后不良反应发生率差异无统计学意义。结论慢性乙型肝炎剖宫产产妇术后镇痛中羟考酮能激活T细胞,而吗啡引起Th1细胞抑制。
[Abstract]:Objective to investigate the effect of postoperative analgesia with hydroxycodone on T cell function in chronic hepatitis B cesarean section parturient. Methods 60 cases of chronic hepatitis B parturient who were given cesarean section under combined spinal-epidural anesthesia were randomly divided into two groups, 30 cases in each group. Postoperative intravenous analgesia was performed with hydroxycodone 0.8mg/kg (group O) and morphine 0.8mg/kg (group M). The formula of analgesic pump was diluted to 100ml with saline, the background volume was 2ml / h, and the locking time was 15min. The immune cells (Th1 Th2 cells) and biochemical indexes were recorded immediately after operation and 24 hours after operation. The number of times of analgesia pump and the cumulative dosage of analgesic were recorded within 24 hours after operation. Postoperative adverse reactions were recorded. Results Th1 in group O was significantly higher than that in group M (P0.05). There was no significant difference in the changes of Th1 Th2 cells between two groups. The total pressing times and the cumulative dosage of analgesics in group O were significantly lower than those in group M (P0.05). There was no significant difference in the incidence of postoperative adverse reactions between the two groups. Conclusion during postoperative analgesia with chronic hepatitis B cesarean section, oxycodone activates T cells, while morphine inhibits Th1 cells.
【作者单位】：东南大学附属第二医院麻醉科;东南大学附属中大医院麻醉科;
【分类号】：R614

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