【摘要】 目的探讨硬膜外自控镇痛(PCEA)对妊娠期高血压疾病患者剖宫产术后机体免疫功能的影响。方法选择妊娠期高血压疾病择期行剖宫产手术的患者60例,随机分为三组:吗啡组(M组)、芬太尼组(F组)和对照组(C组),每组20例,M组以0.15%盐酸罗哌卡因+吗啡40μg/mL行PCEA,F组以0.15%盐酸罗哌卡因+芬太尼2.5μg/mL行PCEA,C组必要时肌肉注射哌替啶50mg。分别测定三组麻醉前(T0)、术后24h(T1)、48h(T2)和72h(T3)VAS镇痛评分以及白细胞介素IL-6、IL-8、IL-10和肿瘤坏死因子α(TNF-α)的浓度。结果在T1和T2M组和F组的VAS评分低于C组,IL-6和IL-8的升高幅度低于C组,而IL-10的升高幅度高于C组。结论硬膜外自控镇痛(PCEA)可增强妊娠高血压疾病患者剖宫产术后的免疫功能。更多还原

【Abstract】 Objective To investigate the effects of the patient-controlled epidural analgesia (PCEA) on the immune function of patients with pregnancy-induced hypertension after cesarean section. Methods Sixty patients with pregnancy-induced hypertension undergoing cesarean section were randomly selected and equally divided into morphine group (M group, 0.15% ropivacaine plus morphine 40 μg/mL), fentanyl group (F group, 0.15% ropivacaine plus fentanyl 2.5 μg/mL) and control group (C group, pethidine 50 mg prn). PCEA was given with a loading dose of 6 mL, a base rate of 12 mL/h and bolus application of 5 mL/20 min. Pain score of visual analog scale (VAS), interleukin-6 (IL-6), interleukin-6 (IL-8), interleukin-6 (IL-10) and tumor necrosis factor α (TNF-α) were measured before anesthesia (T0), postoperative 24 h (T1), postoperative 48 h (T2), and postoperative 72 h (T3). Results In M and F groups, the VAS scores were lower, the expression of IL-6 and IL-8 increased less and IL-10 increased more on T1and T 2 when compared with C group. Conclusions PCEA can improve the immune function of patients with pregnancy-induced hypertension after cesarean section.更多还原