摘要
目的:探讨全身麻醉复合硬膜外麻醉对老年腹部手术患者术后肺部感染以及免疫功能的影响。方法:420例行腹部手术的老年患者,根据随机数字表法分为研究组和对照组(各210例),研究组给予全身麻醉复合硬膜外麻醉,对照组单纯全身麻醉。对比两组患者术前和术后第3天发热、咳痰以及肺部感染的发生情况;对比两组患者术前、术后第1天CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞、CD4^(+)/CD8^(+)、CD3-CD19^(+)B淋巴细胞以及NK细胞水平的变化。结果:研究组与对照组所有患者术前各指标水平差异无统计学意义(P>0.05);研究组患者术后肺部感染发生率明显低于对照组(P<0.01);两组患者术后的CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞、CD4^(+)/CD8^(+)、CD3-CD19^(+)B淋巴细胞以及NK细胞水平与术前比较均明显降低(P<0.01),但研究组患者仍高于对照组降(P<0.01)。结论:全身麻醉复合硬膜外麻醉可有效降低老年患者术后肺部感染风险,同时对免疫功能影响较小,适宜临床手术采用。
Objective:To investigate the effect of general anesthesia combined with epidural anesthesia on postoperative pulmonary infection and immune function in elderly patients undergoing abdominal surgery.Method:420 elderly patients with abdominal surgery were randomly divided into study group and control group(210 cases in each group).The incidence of fever,expectoration and pulmonary infection were compared between the two groups before and 3 days after operation;the changes of CD3^(+),CD4^(+),CD8^(+)T lymphocytes,CD4^(+)/CD8^(+),CD3-CD19^(+)B lymphocytes and NK cells were compared between the two groups before and 1 day after operation.Results:There was no significant difference in the preoperative lung condition and the levels of CD3^(+),CD4^(+),CD8^(+)T lymphocytes,CD4^(+)/CD8^(+)、CD3-CD19^(+)B lymphocytes and NK cells between the study group and the control group(P>0.05);The incidence of fever,expectoration,dry and wet rales and pulmonary infection in the study group was significantly lower than that in the control group(P<0.01);The number of CD3^(+),CD4^(+),CD8^(+)T lymphocytes,CD4^(+)/CD8^(+),CD3-CD19^(+)B lymphocytes and NK cells in the two groups after operation was significantly lower than that before operation(P<0.01),however,the indexes in the study group were still higher than those in the control group(P<0.01).Conclusion:General anesthesia combined with epidural anesthesia can effectively reduce the risk of postoperative pulmonary infection in elderly patients,and has little effect on the reduction of immune function,so it is suitable for clinical operation.
作者
李澍
LI Shu(Sixth Medical Center of PLA General Hospital, Beijing 100048,China)
出处
《微循环学杂志》
2021年第2期41-45,共5页
Chinese Journal of Microcirculation
关键词
全身麻醉
硬膜外麻醉
老年
腹部手术
肺部感染
免疫功能
General anesthesia
Epidural anesthesia
Elderly
Abdominal surgery
Pulmonary infection
Immune function
