摘要
目的探讨不同麻醉方式下行腹部良性肿瘤切除术老年患者术后肺部感染情况。方法择期行腹部良性肿瘤切除术老年患者45例,其中20例采用全凭静脉麻醉(全凭静脉麻醉组),25例采用硬脊膜外阻滞复合全身麻醉(硬脊膜外麻醉组),分别于麻醉前、术后6、24、72h检测2组白细胞介素(interleukin,IL)-6、IL-8、CD4^+/CD8^+水平,比较2组术后14d内肺部感染发生率。结果术后14d内,全凭静脉麻醉组肺部感染率(20.0%)高于硬脊膜外麻醉组(4.0%)(P<0.05);术后6、24h,全凭静脉麻醉组IL-6[(34.23±5.11)、(33.12±5.12)μg/L]、IL-8[(56.72±9.68)、(50.11±7.83)μg/L]高于麻醉前[(29.71±4.52)、(33.87±6.72)μg/L],CD4^+/CD8^+(1.58±0.22、1.51±0.18)低于麻醉前(1.63±0.23)(P<0.05);硬脊膜外麻醉组术后6hIL-6[(31.11±4.49)μg/L]、IL-8[(47.23±8.23)μg/L]高于麻醉前[(29.72±4.56)、(33.91±6.74)μg/L](P<0.05);全凭静脉麻醉组术后6、24h的IL-6、IL-8水平高于硬脊膜外麻醉组,CD4^+/CD8^+水平低于硬脊膜外麻醉组,差异均有统计学意义(P<0.05)。结论与全凭静脉麻醉相比,老年患者腹部良性肿瘤切除手术采用硬脊膜外阻滞复合全身麻醉可降低术后肺部感染发生率,对患者免疫功能影响较小。
Objective To investigate pulmonary infection after benign abdominal tumor resection under different anethesia methods in elderly patients. Methods In 45 elderly patients with benign abdominal tumors scheduled for tumor resection, 20 patients received total intravenous anesthesia （TIVA） （TIVA group）, and 25 patients received epidural anesthesia combined with general anaesthesia （epidural group）. The levels of interleukin （IL）-6, IL-8 and CD4＋/CD8＋ were detected before anesthesia, and 6, 24 and 72 h after operation, and compared between two groups. The pulmonary infection rate was also compared between two groups in 14 d after operation. Results The pulmonary infection rate was significantly higher in TIVA group （20.0%） than that in epidural group （4.0%） in 14 d after operation （P〈0.05）. The levels of IL-6 （（34.23±5.11）, （33.12±5.12） μg/L） and IL-8 （（56.72±9.68）, （50. 11±7.83）μg/L） in 6 and 24 h after operation were significantly higher than those before anesthesia （（29. 71±4. 52）, （33. 87±6. 72） μg/L） （P〈 0.05）, and CD4＋/CD8＋ （（1.58±0.22, 1.51±0.18） were significantly lower than that before anesthesia （1.63±0.23） （P〈0. 05） in TIVA group. The levels of IL-6 （（31. 11±4. 49） μg/L） and IL-8 （（47. 23 ±8. 23） μg/L） were significantly higher in 6 h after operation than those before anesthesia （（29. 72±4.56）, （33.91±6.74）μg/L） in epidural group （P〈0.05）. The levels of IL-6 and IL-8 in TIVA group were significantly higher than those in epidural group in 6 and 24 h after anethesia, and CD4＋/CD8＋ was significantly lower than that in epidural group （P〈0.05）. ConclusionEpidural anesthesia combined with general anaesthesia can reduce the pulmonary infection rate after benign abdominal tumor resection in elderly patients, with less influence on immune function in comparison with TIVA. Key words ： Benign tumor; abdomen; pulmonary infection; total intravenous anesthesia; e
出处
《中华实用诊断与治疗杂志》
2016年第8期826-828,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
江西省医学会2012年度科研项目(2011-NO.N047)
