發(fā)布時間：2018-07-03 09:03

  本文選題：硬膜外麻醉 + 腰硬聯(lián)合麻醉��； 參考：《中國老年學(xué)雜志》2016年09期

【摘要】：目的比較硬膜外麻醉及腰硬聯(lián)合麻醉對骨水泥半髖置換術(shù)老年患者免疫功能及激素水平的影響。方法擇期行骨水泥半髖關(guān)節(jié)置換術(shù)的60例老年患者隨機分為A組和B組,分別硬膜外麻醉和腰硬聯(lián)合麻醉后進行骨水泥半髖置換術(shù)。比較兩組術(shù)中出血量、輸液量和輸血量及手術(shù)時間,分別于麻醉前(T0)、骨水泥注入前(T1)、骨水泥注入時(T2)、手術(shù)結(jié)束時(T3)、術(shù)后24 h(T4)和術(shù)后48 h(T5)抽取血樣測定兩組血清激素水平和免疫細胞水平。結(jié)果 1兩組術(shù)中出血量、輸液量、輸血量和手術(shù)時間差異均無統(tǒng)計學(xué)意義(P0.05);2B組CD4+和CD4+/CD8+在T1、T2、T3和T4時均較A組顯著降低(P0.05或P0.01),CD8+均較A組顯著升高(P0.01);3B組T1、T2、T3、T4和T5時皮質(zhì)醇(Cor)、去甲腎上腺素(NE)和腎上腺素(Adr)水平顯著低于A組(P0.01)。結(jié)論老年骨水泥半髖置換術(shù)患者采用腰硬聯(lián)合麻醉較硬膜外麻醉對免疫細胞及激素水平影響較小,利于術(shù)后恢復(fù)。
[Abstract]:Objective to compare the effects of epidural anesthesia and combined spinal-epidural anesthesia on immune function and hormone level in elderly patients undergoing bone cement hemiarthroplasty. Methods Sixty elderly patients undergoing bone cement hemihip replacement were randomly divided into two groups: group A and group B. After epidural anesthesia and combined spinal-epidural anesthesia, bone cement semi-hip replacement was performed. The amount of blood loss, transfusion, blood transfusion and operation time were compared between the two groups. Before anesthesia (T 0), before bone cement injection (T 1), during bone cement injection (T 2), at the end of operation (T 3), 24 h after operation (T 4) and 48 h after operation (T 5), the serum hormone level and immune cell level were measured. Results 1Intraoperative blood loss and transfusion volume in the two groups; There was no significant difference in blood transfusion volume and operation time (P0.05). CD4 and CD4 / CD8 in group B were significantly lower than those in group A (P0.05 or P0.01). CD8 was significantly higher in group B than in group A (P0.01). The levels of T1T2T2T3T4 and T5 cortisol (Cor), norepinephrine (NE) and epinephrine (Adr) in group B were significantly higher than those in group A (P0.01). The level was significantly lower than that in group A (P0.01). Conclusion the effect of combined spinal-epidural anesthesia on immune cells and hormone levels in elderly patients with bone cement hemihip replacement is less than that of epidural anesthesia, which is beneficial to postoperative recovery.
【作者單位】： 四川省人民醫(yī)院城東病區(qū)麻醉科;奧斯迪康骨醫(yī)院麻醉科;
【基金】：國家自然科學(xué)基金委員會醫(yī)學(xué)科學(xué)部項目(No.61401258)
【分類號】：R614

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