Postoperative immune function after different anesthesia methods for pediatric laparoscopic hernia repair

doi:10.3877/cma.j.issn.1674-392X.2018.04.019

Abstract

Abstract:

Objective

To investigate the effect of sevoflurane inhalation laryngeal mask airway anesthesia compared with sacral block combined with sevoflurane inhalation laryngeal mask airway anesthesia on postoperative specific cellular immune function in children with indirect hernia after laparoscopic surgery.

Methods

Prospectively collected 100 cases of Pediatric casts treated in Dongguan City Maternal and Child Health Hospital from January 2015 to June 2017. According to the random table method, 50 cases were divided into experimental group and control group, respectively. In the experimental group, sevoflurane was used to block the inhaled laryngeal mask with general anesthesia. The control group was treated with sevoflurane inhaled laryngeal mask. The effect of different anesthesia methods on cellular immune function in laparotomy laparoscopic surgery in two groups of children were analyzed statistically.

Results

The results showed that after 2 h, 24 h the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ values in both groups were lower than those before anesthesia, but the control group decreased more significantly, the difference was statistically significant (P<0.05), no statistically significant difference in the test group (P>0.05); the change of the CD8⁺ value of the two groups before and after surgery was small, the difference was not statistically significant (P>0.05). The CD3⁺, CD4⁺, CD4⁺/CD8⁺ values of the control group at 24 h after surgery were significantly lower than those of the experimental group and the difference was statistically significant (P<0.05). Compared with before anesthesia, the IL-10 levels at 24 h and 72 h after operation in the two groups were significantly increased, the differences were statistically significant (P<0.05).

Conclusion

Sacral block combined with sevoflurane inhalation laryngeal mask anesthesia has less influence on the specific cellular immune function after laparoscopic surgery in children with indirect inguinal hernia, and it is beneficial to the recovery of children with relatively low immune function.

Key words: Indirect hernia, Child, Laparoscopes, Anesthesia, general, Immune function

Canfeng Zhuang, Zhiyong Wang, Jinlong Fang. Postoperative immune function after different anesthesia methods for pediatric laparoscopic hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(04): 306-310.

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Figures/Tables 2

References 18

[1]	陈易, 赵军锋, 林杰, 等. 应用腹腔镜治疗小儿对侧未闭隐匿性鞘状突[J]. 中华小儿外科杂志, 2016, 37(10): 750-753.
[2]	方小三, 王小明, 胡明华, 等. 腹腔镜与传统手术治疗小儿疝气的临床效果分析[J]. 中国现代普通外科进展, 2015, 18(3): 235-237.
[3]	Saber A, Hokkam EN, Ellabban GM. Laparoscopic transabdominal preperitoneal approach for recurrent inguinal hernia: A randomized trial[J]. J Minim Access Surg, 2015, 11(2): 123-125.
[4]	周晓筠, 吴靦, 朱毅, 等. 不同麻醉方法对小儿腹腔镜手术应激反应和复苏质量的影响[J]. 实用医学杂志, 2017, 33(13): 2186-2188.
[5]	张永乐, 王怀明. 经外环口行小儿斜疝疝囊高位结扎手术的优势及手术技巧[J]. 中国现代普通外科进展, 2015, 18(9): 729-729.
[6]	杨银娣. 小儿疝气腹腔镜手术的临床应用价值及围手术期的舒适护理[J]. 齐齐哈尔医学院学报, 2015, 36(17): 2647-2648.
[7]	段永福, 赵成鹏, 周晓波, 等. 腹腔镜与传统手术治疗小儿腹股沟斜疝的对比研究[J]. 中国微创外科杂志, 2017, 17(3): 234-236.
[8]	Raveenthiran V, Agarwal P. Choice of Repairing Inguinal Hernia in Children: Open Versus, Laparoscopy[J]. Indian J Pediatr, 2017, 84(7): 1-9.
[9]	明葛东, 朱鸿喜, 孟德诚. 用腹腔镜手术治疗小儿腹股沟斜疝的效果分析[J]. 当代医药论丛, 2016, 14(22): 65-67.
[10]	朱真闯, 闫学强, 杨俊, 等. 经脐双孔腹腔镜手术在小儿腹股沟嵌顿性斜疝中的应用[J]. 临床小儿外科杂志, 2016, 15(5): 473-476.
[11]	Pelizzo G, Bernardi L, Carlini V, et al. Laparoscopy in children and its impact on brain oxygenation during routine inguinal hernia repair[J]. J Minim Access Surg, 2017, 13(1): 51-55.
[12]	王敬. 围手术期应激反应及其调控的新进展[J]. 现代诊断与治疗, 2016, 27(20): 3816-3817.
[13]	周代伟, 陈彬, 梁亚统, 等. 骶管阻滞对小儿下腹部手术经喉罩七氟醚吸入全麻苏醒期躁动的影响[J]. 临床医学工程, 2013, 20(7): 835-836.
[14]	PogoreliZ, Rikalo M, Juki M, et al. Modified Marcy repair for indirect inguinal hernia in children: a 24-year single-center experience of 6826 pediatric patients[J]. Surg Today, 2016, 47(1): 1-6.
[15]	叶洁云, 谈宇政, 李敏梅. 喉罩七氟醚吸入麻醉用于小儿疝气修补手术的临床分析[J]. 北方药学, 2016, 13(10): 193-194.
[16]	Le RF, Lipsker A, Mesureur S, et al. Inguinal hernia repair in children: Surgical technique[J]. J Visc Surg, 2016, 153(2): 121-125.
[17]	马宇, 苏佳灿, 陈建芳, 等. 区域神经阻滞技术在创伤胫腓骨骨折患者麻醉中的应用[J]. 第二军医大学学报, 2016, 37(11): 1406-1409.
[18]	苏震, 李建玲, 李汝泓, 等. 右美托咪定用于全麻联合区域阻滞下小儿腹股沟区手术的效果[J]. 现代中西医结合杂志, 2016, 25(29): 3286-3288.

组别		CD3⁺(%)	CD4⁺(%)	CD8⁺(%)	CD4⁺/CD8⁺
对照组	麻醉前	64.78±7.12	37.92±6.18	23.47±6.94	1.62±0.89
?	术后2 h	55.73±6.82^a	34.57±6.42^a	23.38±7.88	1.48±0.81^a
	t值	4.261	5.028	1.232	4.975
	P值	0.017	0.023	0.422	0.036
	术后24 h	51.44±5.19	27.81±6.27	23.11±6.57	1.20±0.95
	t值	3.940	4.521	2.549	4.038
	P值	0.033	0.041	0.217	0.025
	术后72 h	62.97±6.21	36.53±6.62	23.31±6.87	1.57±0.96
?	t值	2.438	2.173	1.965	2.026
?	P值	0.462	0.518	0.263	0.405
试验组	麻醉前	65.37±6.31	37.72±5.74	23.27±7.39	1.62±0.78
?	术后2 h	60.31±6.58	35.29±6.89	22.87±7.79	1.54±0.88
?	t值	2.304	2.615	1.734	1.520
?	P值	0.631	0.527	0.426	0.673
?	t^a值	3.420	5.86	4.391	5.384
?	P^a值	0.026	0.019	0.515	0.017
?	术后24 h	57.11±7.09	34.82±6.15	23.06±7.39	1.51±0.83
?	t值	1.370	1.571	2.047	2.326
?	P值	0.306	0.264	0.452	0.520
?	t^b值	2.015	3.404	0.827	3.579
?	P^b值	0.030	0.018	0.415	0.026
?	术后72 h	64.91±7.81	36.83±6.22	24.37±8.13	1.51±0.76
?	t值	2.438	0.947	1.370	0.816
?	P值	0.612	0.203	0.154	0.328
?	t^c值	1.384	1.092	0.374	0.586
?	P^c值	0.820	0.251	0.374	0.493

组别		CD3⁺(%)	CD4⁺(%)	CD8⁺(%)	CD4⁺/CD8⁺
对照组	麻醉前	64.78±7.12	37.92±6.18	23.47±6.94	1.62±0.89
?	术后2 h	55.73±6.82^a	34.57±6.42^a	23.38±7.88	1.48±0.81^a
	t值	4.261	5.028	1.232	4.975
	P值	0.017	0.023	0.422	0.036
	术后24 h	51.44±5.19	27.81±6.27	23.11±6.57	1.20±0.95
	t值	3.940	4.521	2.549	4.038
	P值	0.033	0.041	0.217	0.025
	术后72 h	62.97±6.21	36.53±6.62	23.31±6.87	1.57±0.96
?	t值	2.438	2.173	1.965	2.026
?	P值	0.462	0.518	0.263	0.405
试验组	麻醉前	65.37±6.31	37.72±5.74	23.27±7.39	1.62±0.78
?	术后2 h	60.31±6.58	35.29±6.89	22.87±7.79	1.54±0.88
?	t值	2.304	2.615	1.734	1.520
?	P值	0.631	0.527	0.426	0.673
?	t^a值	3.420	5.86	4.391	5.384
?	P^a值	0.026	0.019	0.515	0.017
?	术后24 h	57.11±7.09	34.82±6.15	23.06±7.39	1.51±0.83
?	t值	1.370	1.571	2.047	2.326
?	P值	0.306	0.264	0.452	0.520
?	t^b值	2.015	3.404	0.827	3.579
?	P^b值	0.030	0.018	0.415	0.026
?	术后72 h	64.91±7.81	36.83±6.22	24.37±8.13	1.51±0.76
?	t值	2.438	0.947	1.370	0.816
?	P值	0.612	0.203	0.154	0.328
?	t^c值	1.384	1.092	0.374	0.586
?	P^c值	0.820	0.251	0.374	0.493

组别		肾上腺素	去甲肾上腺素	IL-6	IL-10
对照组	麻醉前	46.07±5.57	283.22±26.27	43.6±5.63	38.9±9.73
?	术后2 h	96.08±5.42	303.87±27.32	43.27±8.13	39.42±7.55
?	t值	4.582	2.035	1.530	1.472
?	P值	0.037	0.142	0.549	0.261
?	术后24 h	284.33±13.35	520.83±18.76	86.4±4.57	71.5±3.21
?	t值	4.376	5.831	3.750	4.053
?	P值	0.012	0.039	0.025	0.040
?	术后72 h	147.82±11.01	387.62±12.38	44.8±6.17	88.12±4.62
?	t值	3.840	3.651	1.937	7.283
?	P值	0.033	0.015	0.354	0.006
试验组	麻醉前	46.11±3.82	287.09±42.82	41.3±5.67	36.4±8.42
?	术后2 h	93.96±8.09	296.96±31.87	42.72±8.26	38.2±7.29
?	t值	5.602	1.048	1.974	2.048
?	P值	0.026	0.081	0.075	0.639
?	t^a值	2.438	1.394	0.457	1.583
?	P^a值	0.279	0.436	0.582	0.620
?	术后24 h	99.41±8.12	358.47±11.07	84.6±5.57	79.7±3.72
?	t值	4.985	3.503	5.068	4.961
?	P值	0.008	0.033	0.016	0.030
?	t^b值	5.663	3.016	1.037	2.980
?	P^b值	0.020	0.012	0.236	0.704
?	术后72 h	51.42±7.86	295.69±10.04	42.3±4.39	95.3±5.33
?	t值	1.206	2.485	2.817	5.665
?	P值	0.374	0.153	0.265	0.046
?	t^c值	5.084	4.677	2.592	1.960
?	P^c值	0.016	0.018	0.875	0.947

组别		肾上腺素	去甲肾上腺素	IL-6	IL-10
对照组	麻醉前	46.07±5.57	283.22±26.27	43.6±5.63	38.9±9.73
?	术后2 h	96.08±5.42	303.87±27.32	43.27±8.13	39.42±7.55
?	t值	4.582	2.035	1.530	1.472
?	P值	0.037	0.142	0.549	0.261
?	术后24 h	284.33±13.35	520.83±18.76	86.4±4.57	71.5±3.21
?	t值	4.376	5.831	3.750	4.053
?	P值	0.012	0.039	0.025	0.040
?	术后72 h	147.82±11.01	387.62±12.38	44.8±6.17	88.12±4.62
?	t值	3.840	3.651	1.937	7.283
?	P值	0.033	0.015	0.354	0.006
试验组	麻醉前	46.11±3.82	287.09±42.82	41.3±5.67	36.4±8.42
?	术后2 h	93.96±8.09	296.96±31.87	42.72±8.26	38.2±7.29
?	t值	5.602	1.048	1.974	2.048
?	P值	0.026	0.081	0.075	0.639
?	t^a值	2.438	1.394	0.457	1.583
?	P^a值	0.279	0.436	0.582	0.620
?	术后24 h	99.41±8.12	358.47±11.07	84.6±5.57	79.7±3.72
?	t值	4.985	3.503	5.068	4.961
?	P值	0.008	0.033	0.016	0.030
?	t^b值	5.663	3.016	1.037	2.980
?	P^b值	0.020	0.012	0.236	0.704
?	术后72 h	51.42±7.86	295.69±10.04	42.3±4.39	95.3±5.33
?	t值	1.206	2.485	2.817	5.665
?	P值	0.374	0.153	0.265	0.046
?	t^c值	5.084	4.677	2.592	1.960
?	P^c值	0.016	0.018	0.875	0.947

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