摘要
目的探讨舒芬太尼和瑞芬太尼麻醉对先天性心脏病介入手术患儿心功能和免疫功能的影响。方法收集2018年1月至2021年12月于邯郸市中心医院接受介入手术的120例先天性心脏病患儿,按照随机数字表法分为瑞芬太尼组和舒芬太尼组,每组各60例,分别使用瑞芬太尼和舒芬太尼麻醉。观察并比较麻醉期间两组患儿心功能指标、血流动力学指标及不良反应发生情况,并比较两组患儿手术前后外周血免疫功能变化。结果麻醉诱导前两组患儿的心率(HR)、收缩压(SBP)和舒张压(DBP)差异均无统计学意义(P>0.05)。与麻醉诱导前比较,麻醉诱导后两组患儿SBP和DBP均明显下降,而瑞芬太尼组患儿HR、SBP和DBP明显高于舒芬太尼组(P<0.05);麻醉诱导后两组患儿血清乙酰胆碱(ACH)、乳酸水平均显著升高,而瑞芬太尼组患儿这些指标水平显著低于舒芬太尼组患儿(P<0.05);麻醉期间瑞芬太尼组患儿不良反应的发生率显著少于舒芬太尼组患儿(P<0.05)。术后1 d、术后3 d患儿外周血白细胞计数、CD4^(+)/CD8^(+)T淋巴细胞比值显著升高,而瑞芬太尼组患儿这些指标水平显著低于舒芬太尼组患儿(P<0.05)。结论与舒芬太尼相比,瑞芬太尼在先天性心脏手术中麻醉应激反应及对术后免疫功能的影响较小。
Objective To investigate the effects of sufentanil and remifentanil anesthesia on cardiac function and immune function in children with congenital heart disease undergoing interventional surgery.Methods A total of 120 children with congenital heart disease who received interventional surgery in our hospital were divided into remifentanil group and sufentanil group according to random number table,with 60 cases in each group.Remifentanil group and sufentanil group were anesthetized with remifentanil and sufentanil group during surgery,respectively.Cardiac function,hemodynamic indexes and adverse reactions were observed and compared between the two groups during anesthesia,and changes in peripheral blood immune function were compared between the two groups after surgery.Results There were no significant differences in heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)between 2 groups before anesthesia induction(P>0.05).Compared with the group before anesthesia induction,the levels of SBP and DBP in the two groups were significantly decreased after anesthesia induction,while the levels of HR,SBP and DBP in remifentanil group were significantly higher than those in sufentanil group after anesthesia induction(P<0.05).After anesthesia induction,serum levels of ACH and lactic acid in 2 groups were significantly increased,while the levels of these indexes in remifentanil group were significantly lower than those in sufentanil group(P<0.05).The incidence of adverse reactions in remifentanil group was significantly lower than that in Sufentanil group(P<0.05).The white cells and the ratio of CD4^(+)/CD8^(+)T lymphocytes in peripheral blood were significantly increased 1 and 3 days after operation,while the levels of these indexes in remifentanil group were significantly lower than those in sufentanil group(P<0.05).Conclusions Compared with sufentanil,remifentanil has less effect on anesthesia stress response and abnormal postoperative immune function in congenital heart surgery.
作者
刘新燕
孙颜
孙天泽
陈永学
王新波
段静辉
侯俊德
LIU Xinyan;SUN Yan;SUN Tianze;CHEN Yongxue;WANG Xinbo;DUAN Jinghui;HOU Junde(Department of Anesthesiology,Handan Central Hospital,Handan 056001,Hebei,China)
出处
《中国分子心脏病学杂志》
CAS
2023年第5期5675-5680,共6页
Molecular Cardiology of China
基金
河北省科技计划项目(212777196)。
关键词
瑞芬太尼
舒芬太尼
先天性心脏病
儿童
心功能
免疫功能
Remifentanil
Sufentanil
Congenital heart disease
Children
Cardiac function
Immune function
