Objective: To observe changes of T lymphocyte subgroups in the peripheral blood in cholecystectomy patients undergoing acupuncture anesthesia combined with epidural administration of small dose of anesthetics for studying the effect of acupuncture analgesia on the immuno functional activity. Methods: A total 20 cases of cholecystitis plus cholelithiasis patients were randomly divided into acupuncture combined with epidural anesthesia (ACEA) group (n=10) and epidural anesthesia (EA) group (n=10). Blood samples (2 mL/time) were collected from the peripheral vein before, during and on the 5th day after operation for isolating lymphocytes that were stained with immunocytochemical technique. For comparison, blood samples of control group were collected from 10 cases of healthy people. Results: ① Before anesthesia, there were no significant differences among the 3 groups in the number of CD 3 +, CD 4 + and CD 8 + and the ratio of CD 4 + and CD 8 + (P>0.05). ② During operation, CD 3 +, CD 4 + and CD 8 + of ACEA group were obviously more than those of EA group (P<0.05). On the 5th day after operation, the number of CD 3 +, CD 4 + and CD 8 + of ACEA group was still obviously higher than that of EA group (P<0.05). ④ Comparison of CD 3 +, CD 4 + and CD 8 + and CD 4 + /CD 8 + before, during and after operation in ACEA group showed no significant differences, while in EA group, the number of T lymphocyte subgroups was decreased slightly, except for CD 4 +(P<0.05). Conclusion: Acupuncture could strengthen the analgesic effect of anesthetics, lower the dose of epidural anesthetics and raise lymphocyte mediated immunocompetence.
目的观察不同镇痛方法对上腹部手术合并高血压病患者血浆内皮素(ET)及心钠素(ANP)的影响。方法30例拟行上腹部手术的高血压患者根据不同镇痛方式随机分为三组:A组为对照组,术后根据需要间断肌注哌替啶镇痛;B组术后行硬膜外自控镇痛(PCEA);C组术后行静脉自控镇痛(PCIA)。采用放免法测定术前、术毕、术后24 h、术后48 h血浆ET及ANP浓度;监测HR、BP及进行VAS评分。结果 B组及C组术后24 h ET及ANP值显著低于A组(P<0.05),且B组降低幅度更大(P<0.01),持续时间更长,至术后48 h B组仍低于A组(P<0.05),而C组与A组比较差异无显著性。B及C组术后HR、SBP、DBP及VAS评分显著低于同期A(P<0.05),且B组数值更低(P<0.01)。结论术后镇痛能有效减轻上腹部手术病人疼痛、改善循环功能、降低高血压病患者上腹部手术后ET及ANP值,减少术后并发症,有利于病人恢复,且PCEA效果更优。
