摘要
目的评价利多卡因复合硫酸镁静脉注射对全麻腹腔镜手术患者围手术期免疫应激的影响。方法择期行全麻腹腔镜手术的患者76例,年龄18~65岁,美国麻醉医师协会分级Ⅰ、Ⅱ级,按随机数字表法分为两组(每组38例):对照组(C组)采用全凭静脉麻醉,试验组(L组)采用全凭静脉麻醉联合利多卡因复合硫酸镁静脉注射。记录两组患者一般资料(年龄、身高、体重、手术时间、麻醉时间),记录两组患者入室时(T_(1))、拔管后(T_(2))、术后2 d(T_(3))的CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、自然杀伤(NK)细胞、B细胞百分比及CD4^(+)/CD8^(+),酶联免疫吸附测定(ELISA)法检测两组患者血浆超敏C反应蛋白(hs-CRP)、γ-干扰素(IFN-γ)、前列腺素F2α(PGF2α)、前列腺素E2(PGE2)浓度,记录两组患者T_(3)时15项恢复质量量表(QoR-15)评分及术后住院时间。结果两组患者一般资料差异均无统计学意义(均P>0.05)。L组患者T_(3)时QoR-15评分高于C组(P<0.05),两组患者术后住院时间差异无统计学意义(P>0.05)。与T1时比较:C组患者T_(2)时CD3^(+)T细胞百分比、CD4^(+)T细胞百分比、CD4^(+)/CD8^(+)均降低(均P<0.05),NK细胞百分比升高(P<0.05);L组患者T2时NK细胞百分比升高(P<0.05),T_(3)时CD4^(+)T细胞百分比、B细胞百分比均升高(均P<0.05),NK细胞百分比降低(P<0.05)。与T_(2)时比较:两组患者T_(3)时CD3^(+)T细胞百分比、CD4^(+)T细胞百分比、B细胞百分比均升高(均P<0.05),NK细胞百分比降低(P<0.05),C组患者T_(3)时CD4^(+)/CD8^(+)升高(P<0.05)。与C组比较,L组患者T_(2)、T_(3)时CD4^(+)T细胞百分均较高,NK细胞百分均较低,T_(2)时CD3^(+)T细胞百分比较高(均P<0.05)。与T_(1)时比较,两组患者T_(3)时hs-CRP、IFN-γ浓度均升高(均P<0.05),L组患者T2时PGF2α、PGE2浓度均降低(均P<0.05);与T_(2)时比较,两组患者T3时hs-CRP、IFN-γ浓度均升高(均P<0.05),L组患者T_(3)时PGF2α、PGE2浓度均升高(均P<0.05)。与C组
Objective To evaluate the effect of intravenous infusion of lidocaine combined with magnesium sulfate on periop⁃erative immunological stress in patients undergoing laparoscopic surgery with general anesthesia.Methods Seventy⁃six patients,aged 18-65 y,of the American Society of Anesthesiologists physical statusⅠorⅡ,undergoing laparoscopic surgery with general anes⁃thesia,were divided into 2 groups(n=38)according to the random number table mothod:experiment group(group L)and control group(group C).The group C received intravenous anesthesia only,while the group L received intravenous anesthesia combined with intrave⁃nous infusion of lidocaine combined with magnesium sulfate.Their general information were recorded(including age,height,weight,surgery time and anesthesia time);the percentages of CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,natural killer(NK)cells,B cells,and CD4^(+)/CD8^(+)at the time points of entry(T_(1)),after extubation(T_(2)),and 2 d after surgery(T_(3))for two groups of patients.Enzyme⁃linked immunosorbent assay(ELISA)was used to detect the concentrations of plasma high⁃sensitivity C⁃reactive protein(hs-CRP),interferon-γ(IFN-γ),prostaglandin F2(PGF2a),and prostaglandin E2(PGE2)in two groups of patients.The 15⁃item Quality of Recovery(OoR-15)score and postoperative hospital stay time were recorded.Results There was no statistical difference in general information between two groups(all P>0.05).The QoR-15 score at T_(3) in group L is higher than that in group C(P<0.05),while there is no significant differ⁃ence in postoperative hospital stay time between the two groups(P>0.05).Compared with the percentage at T_(1):the percentage of CD3^(+)T cells,CD4^(+)T cells,and CD4^(+)/CD8^(+)in group C decreased at T_(2)(all P<0.05),while the percentage of NK cells increased(P<0.05)at T_(2);the percentage of NK cells in group L increased(P<0.05)at T_(2) but decreased at T_(3)(P<0.05),the percentage of CD4^(+)T cells and B cells increased(all P<0.05)at T_(3).Compared with the percentages
作者
王鑫智
尹鹏程
王瑞
张林忠
Wang Xinzhi;Yin Pengcheng;Wang Rui;Zhang Linzhong(School of Anesthesiology,Shanxi Medical University,Taiyuan 030001,China;Department of Anesthesiology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《国际麻醉学与复苏杂志》
CAS
2024年第9期934-938,共5页
International Journal of Anesthesiology and Resuscitation
基金
山西省回国留学人员科研资助项目(2021-170)。
关键词
利多卡因
硫酸镁
免疫
应激
全身麻醉
腹腔镜手术
Lidocaine
Magnesium sulfate
Immune
Stress
General anesthesia
Laparoscopy surgery
