不同术后镇痛模式对红细胞免疫功能的影响

目的探讨不同术后镇痛模式对红细胞免疫功能的影响。方法50例妇科手术患者,按术后不同镇痛模式分为硬膜外自控镇痛(PCEA)组和静脉自控镇痛(PCIA)组。并分别于术前、术后1、3、7 d采静脉血样检测红细胞C3b受体花环率(RCR)、红细胞免疫复合物花环率(RICR)、红细胞免疫粘附促进因子(RFER)和红细胞免疫粘附抑制因子(RFIR)。结果与术前比,PCEA组术后1 d RCR、RFER显著上升(P<0.05),RFIR显著下降(P<0.05),术后3 d RCR、RFER仍显著上升(P<0.05),而RICR显著下降(P<0.05);PCIA组术后1 d RCR、RFER显著下降(P<0.05),RFIR、RICR显著上升(P<0.05);PCIA组术后1、3 d RCR、RFER比PCEA组显著降低(P<0.05),而RICR显著上升(P<0.05);两组各参数在术后7 d基本恢复至术前水平。结论PCEA对红细胞免疫功能的稳定和恢复作用明显强于PCIA。

Effects of postoperative analgesia with different methods on erythrocyte immunity

Objective To investigate the effects of postoperative analgesia with different methods on erythrocyte immunity. Methods Fifty postoperative patients were randomly divided into patient controlled epidural analgesia (group PCEA, n= 25) and patient controlled intravenous analgesia (group PCIA,n=25). Venous blood samples were taken before operation, on the 1st, 3rd and 7th postoperative day to measure rosette rate of erythrocyte C3b receptor ( RCR), the immune complexes rosette rate of red blood cell(RICR) ,the red blood cell immune adherence enhance factor rate(RFER) and the red blood cell adherence inhibitor factor rate(RFER). Results (1)Compared with the baselines, RCR and RFER increased significantly, RFIR decreased significantly on the 1st postoperative day. RCR and RFER got even higher,but RICR decreased significantly on the 3rd postoperative day in group PCEA(P<0. 05). RCR and RFER were significantly higher, RFIR and RICR were lower than those before operation in group PCIA(P<0. 05). (2) RCR and RFER were lower, RFIR and RICR were significantly higher in group PCIA than those in group PCEA on the 1st postoperative day(P< 0. 05). There was no significant difference in above parameters between two the groups on the 7th postoperative day (P>0. 05). Conclusion The effect of postoperative PCEA is more efficient than that of PCIA in stabilizing and maintaining erythrocyte immunity.