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目的:探讨静脉全麻和静脉全麻复合硬膜外麻醉对腹腔镜下行卵巢肿瘤剥除术患者红细胞免疫功能的影响。方法:收集行腹腔镜下卵巢肿瘤剥除术患者120例,随机分成全麻复合硬膜外麻醉(A组)和静脉全麻(B组)两组,每组60例。分别于麻醉前(T0)、麻醉后30 min(T1)、术中1 h(T2)、术后24 h(T3)、术后48 h(T4)、术后72 h(T5)6个时间点抽取时静脉血。检测各时间点红细胞免疫功能指标:红细胞C3b受体花结率(RRCR)、红细胞免疫复合物药结率(RRICR)、肿瘤红细胞花结率(RTRR)。结果:两组患者的RRCR、RRICR及RTRR均于T1开始下降,与T0比较差异存在显著性(P<0.05);RRCR于T4时下降至最低点,RRICR及RTRR于T3时下降至最低点,于T5时RRCR、RRICR及RTRR均恢复T0水平。组间比较,两组患者于T0时RRCR、RRICR及RTRR比较,差异无统计学意义(P>0.05),T1至T4时两组患者的RRCR、RRICR及RTRR比较,差异均有统计学意义,以B组下降更明显(P<0.05)。结论:麻醉对腹腔镜卵巢肿瘤剥除术患者的红细胞免疫功能有损伤作用,静脉全麻复合硬膜外麻醉对红细胞免疫功能的影响相对较小。
Objective: To investigate the effects of intravenous general anesthesia and intravenous anesthesia combined with epidural anesthesia on erythrocyte immune function in patients with laparoscopic ovarian tumor excision. Methods: One hundred and twenty patients underwent laparoscopic ovarian tumor resection were randomly divided into general anesthesia combined with epidural anesthesia (group A) and intravenous general anesthesia (group B), 60 cases in each group. Blood samples were collected before anesthesia (T0), 30 min after anesthesia (T1), 1 h (T2), 24 h after operation (T3), 48 h after operation (T4) and 72 h Venous blood drawn at point. The indexes of erythrocyte immune function (RRCR), RRICR (erythrocyte immune complex) and RTRR (tumor erythrocyte rosetting rate) were detected at each time point. Results: The RRCR, RRICR and RTRR of both groups decreased at T1 and were significantly different from T0 (P <0.05); RRCR decreased to the lowest point at T4, RRICR and RTRR decreased to the lowest at T3, RRR, RRICR and RTRR recovered T0 levels at T5. There were no significant differences in RRCR, RRICR and RTRR between two groups at T0 (P> 0.05). There was significant difference in RRCR, RRICR and RTRR between T1 and T4 in both groups Group B decreased more significantly (P <0.05). CONCLUSION: Anesthesia has an impaired erythrocytic immune function in patients with laparoscopic ovarian tumor excision. The effect of intravenous general anesthesia and epidural anesthesia on erythrocyte immune function is relatively small.