| 吴 丽,薛 娜,吴献伟,赵 欣,王志华.不同剂量羟考酮对腹腔镜胆囊切除术患者血清血栓素A2、血浆内皮素水平和免疫功能的影响[J].,2017,17(25):4864-4868 |
| 不同剂量羟考酮对腹腔镜胆囊切除术患者血清血栓素A2、血浆内皮素水平和免疫功能的影响 |
| Effect of Different Doses of Oxycodone on Plasma Thromboxane A2, Plasma Endothelin Levels and Immune Function of Patients Underwent Laparoscopic Cholecystectomy |
| 投稿时间：2017-04-10 修订日期：2017-04-30 |
| DOI：10.13241/j.cnki.pmb.2017.25.015 |
| 中文关键词: 腹腔镜胆囊切除术 羟考酮 血栓素A2 血浆内皮素 免疫功能 |
| 英文关键词: Laparoscopic cholecystectomy Oxycodone Thromboxane A2 Plasma endothelin Immune function |
| 基金项目:陕西省自然科学基金项目（20131037） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量羟考酮对腹腔镜胆囊切除术患者血清血栓素A2(TXA2)、血浆内皮素(ET)水平和免疫功能的影响。方法：选择2013年8月至2016年8月我院接诊的90例择期行腹腔镜胆囊切除术患者，以随机数表法分为3组，各30例。于手术开始前，均静脉注射羟考酮，A组剂量0.1 mg/kg、B组剂量0.2 mg/kg、C组剂量0.3 mg/kg。比较三组T0(入室后)、T1(麻醉诱导后)、T2(插管后)、T3(胆囊分离时)、T4(手术结束)时点血流动力学、TXA2、ET的变化以及T0、T5(术后2 h)、T6(术后1 d)、T7(术后3 d)时点免疫功能的变化；并记录拔管时间、苏醒时间、降压药、止痛药的使用情况及不良反应的发生情况。结果：三组在T2、T3时点舒张压(DBP)、收缩压(SBP)、心率(HR)较T0时点比较显著升高(P＜0.05)，B、C组在T2、T3时点DBP、SBP、HR均明显低于A组(P＜0.05)；三组T2、T3、T4时点TXA2较T0时点比较均显著升高，且A组＞B组＞C组，两两比较均具有显著差异(P＜0.05)；三组T2、T3时点ET较T0时点均显著升高(P＜0.05)，A组在T2、T3时点ET均明显高于B、C组(P＜0.05)；三组在T5时点CD3+、CD4+、CD8+、CD4+/CD8+较T0时点比较均显著降低(P＜0.05)，A组在T5时点CD3+、CD4+、CD8+、CD4+/CD8+均明显低于B、C组(P＜0.05)；C组拔管时间明显长于A、B组(P＜0.05)；C组不良反应总发生率明显高于A、B组(P＜0.05)。结论：在胆囊切除术中，应用0.2 mg/kg羟考酮对血流动力学、TXA2、ET及免疫功能的影响较小，且安全性高。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of different doses of oxycodone on the serum thromboxane A2(TXA2), plasma endothe- lin(ET) levels and immune function of patients underwent laparoscopic cholecystectomy. Methods: 90 patients of elective laparoscopic cholecystectomy who were treated from August 2013 to August 2016 in our hospital were selected and divided into 3 groups by random number table, with 30 cases in each group. At the beginning of operation, they were given intravenous oxycodone, group A was given 0.1 mg/kg oxycodone, group B was given 0.2 mg/kg oxycodone, group C was given 0.3 mg/kg oxycodone. The changes of hemodynamics, serum TXA2 and ET levels were compared between the three groups at T0 (after admission), T1 (after anesthesia induction), T2 (after in- tubation), T3 (gallbladder separation), T4 (end of surgery) and the changes of immune function was compared at T0, T5 (postoperative 2h),T6(postoperative 1d), T7 (postoperative 3d); and the extubation time, recovery time, hypotensor, additional analgesics situationin and adverse reactions were recorded. Results: The diastolic pressure (DBP), systolic blood pressure (SBP), heart rate (HR) in three groups at T2, T3 point was significantly higher than T0 point(P＜0.05), the DBP, SBP and HR in the B, C groups were significantly lower than the A group at T2 and T3 point(P＜0.05); the TXA2 in three groups at T2, T3, T4 point was significantly higher than T0 point(P＜0.05), and A group＞B group＞C group, there was significant difference between the two groups(P＜0.05); the ET in three groups at T2, T3 point was significantly higher than T0 point(P＜0.05), the ET in the B, C group was significantly higher than the A group at T2, T3 point(P＜0.05); the CD3+, CD4+, CD8+ and CD4+/CD8+ of the three groups at T5 point were significantly lower than that of T0 point(P＜0.05), the CD3+, CD4+, CD8+ and CD4+/CD8+ in A group were significantly lower than that of B, C group at T5 point (P＜0.05); the extubation time in C group was significantly longer than that of A, B group(P＜0.05); the total incidence of adverse reactions in C group was significantly higher than that the A, B group(P＜0.05). Conclusion: In the laparoscopic cholecystectomy, application of 0.2 mg/kg oxycodone had lit-tle effect on hemodynamics, serum TXA2, ET levels and immune function with higher safety. |
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