西南国防医药
西南國防醫藥
서남국방의약
MEDICAL JOURNAL OF NATIONAL DEFENDING FORCES IN SOUTHWEST CHINA
2014年
7期
724-726
,共3页
李广东%朱浩良%隋大凯%邬明
李廣東%硃浩良%隋大凱%鄔明
리엄동%주호량%수대개%오명
肾移植%靶控输注%丙泊酚%瑞芬太尼%应激%细胞免疫
腎移植%靶控輸註%丙泊酚%瑞芬太尼%應激%細胞免疫
신이식%파공수주%병박분%서분태니%응격%세포면역
renal transplantation%target controlled infusion%propofol%remifentanil%stress response%cell immune
目的:探讨靶控输注丙泊酚联合瑞芬太尼麻醉方式对肾移植术患者细胞免疫及应激反应的影响。方法76例肾移植患者行靶控输注丙泊酚联合瑞芬太尼麻醉作为 A 组,行静吸复合麻醉的肾移植患者62例作为 B 组。比较两组麻醉前(T0)、麻醉成功后(T1)、术毕时(T2)、术后24 h(T3)、术后72 h(T4)的心率(HR)、动脉血氧饱和度( SpO2)、平均动脉压(MAP),T 细胞亚群的分布情况,以及血清皮质醇(COR)、白细胞介素-6(IL-6)、C 反应蛋白(CRP)、血糖(GLU)水平。结果A 组 HR 在 T1、T2均分别显著低于 B 组(P ﹤0.05)。T1、T2时 A 组 MAP 显著高于 B 组(P ﹤0.05)。A 组 SpO2在麻醉后各时相与麻醉前相比无显著改变;B 组在 T1、T2均显著低于 T0(P ﹤0.05)。A 组 CD3、CD4、CD8、CD4/ CD8在 T1~ T4均分别显著高于 B 组(P ﹤0.05)。A 组 COR、IL-6、CRP、GLU 在 T1、T2、T3、T4较均显著低于 B 组(P ﹤0.05)。结论丙泊酚联合瑞芬太尼靶控输注能够有效地维持血流动力学稳定,减少机体的应激反应和对细胞免疫的抑制,适宜于肾移植术患者的麻醉。
目的:探討靶控輸註丙泊酚聯閤瑞芬太尼痳醉方式對腎移植術患者細胞免疫及應激反應的影響。方法76例腎移植患者行靶控輸註丙泊酚聯閤瑞芬太尼痳醉作為 A 組,行靜吸複閤痳醉的腎移植患者62例作為 B 組。比較兩組痳醉前(T0)、痳醉成功後(T1)、術畢時(T2)、術後24 h(T3)、術後72 h(T4)的心率(HR)、動脈血氧飽和度( SpO2)、平均動脈壓(MAP),T 細胞亞群的分佈情況,以及血清皮質醇(COR)、白細胞介素-6(IL-6)、C 反應蛋白(CRP)、血糖(GLU)水平。結果A 組 HR 在 T1、T2均分彆顯著低于 B 組(P ﹤0.05)。T1、T2時 A 組 MAP 顯著高于 B 組(P ﹤0.05)。A 組 SpO2在痳醉後各時相與痳醉前相比無顯著改變;B 組在 T1、T2均顯著低于 T0(P ﹤0.05)。A 組 CD3、CD4、CD8、CD4/ CD8在 T1~ T4均分彆顯著高于 B 組(P ﹤0.05)。A 組 COR、IL-6、CRP、GLU 在 T1、T2、T3、T4較均顯著低于 B 組(P ﹤0.05)。結論丙泊酚聯閤瑞芬太尼靶控輸註能夠有效地維持血流動力學穩定,減少機體的應激反應和對細胞免疫的抑製,適宜于腎移植術患者的痳醉。
목적:탐토파공수주병박분연합서분태니마취방식대신이식술환자세포면역급응격반응적영향。방법76례신이식환자행파공수주병박분연합서분태니마취작위 A 조,행정흡복합마취적신이식환자62례작위 B 조。비교량조마취전(T0)、마취성공후(T1)、술필시(T2)、술후24 h(T3)、술후72 h(T4)적심솔(HR)、동맥혈양포화도( SpO2)、평균동맥압(MAP),T 세포아군적분포정황,이급혈청피질순(COR)、백세포개소-6(IL-6)、C 반응단백(CRP)、혈당(GLU)수평。결과A 조 HR 재 T1、T2균분별현저저우 B 조(P ﹤0.05)。T1、T2시 A 조 MAP 현저고우 B 조(P ﹤0.05)。A 조 SpO2재마취후각시상여마취전상비무현저개변;B 조재 T1、T2균현저저우 T0(P ﹤0.05)。A 조 CD3、CD4、CD8、CD4/ CD8재 T1~ T4균분별현저고우 B 조(P ﹤0.05)。A 조 COR、IL-6、CRP、GLU 재 T1、T2、T3、T4교균현저저우 B 조(P ﹤0.05)。결론병박분연합서분태니파공수주능구유효지유지혈류동역학은정,감소궤체적응격반응화대세포면역적억제,괄의우신이식술환자적마취。
Objective To discuss the influence of target controlled infusion of propofol + remifentanil anesthesia on the cell immune function and stress response of renal transplantation patients. Methods 138 renal transplantation patients were randomly divided into 2 groups:group A(n = 76)and group B(n = 62);target controlled infusion of propofol + remifentanil anesthesia was performed in group A,while intravenous inhalational anesthesia in group B;a comparative study was made between the 2 groups on heart rate(HR),mean arterial pressure(MVP),arterial oxygen saturation(SpO2 ),and the levels of corticosteroid(COR),interleukin-6(IL-6),C-reaction protein( CRP),blood glucose( GLU)at each time point of before anesthesia( T0),after anesthesia succeed( T1), operation finished(T2),24 h after operation(T3),and 72 h after operation(T4). Results HR in group A at T1 and T2 was obviously lower than that in group B(P ﹤ 0. 05),while MAP was obviously higher( P ﹤ 0. 05);SpO2 in group A at each time point after anesthesia was of no great difference from that at each time point before anesthesia,while SpO2 in group B at T1 and T2 was much lower than that at T0(P ﹤ 0. 05);COR,IL-6,CRP and GLU in group A at T1,T2,T3 and T4 were much lower than those in group B(P ﹤0. 05). Conclusions Target controlled infusion of propofol + remifentanil anesthesia can effectively maintain the hemodynamic stability and reduce the stress response and the inhibition of cell immune function,and it is applicable for renal transplantation.