Effect of general anesthesia combined with epidural anesthesia on the postoperative immune function, stress state and coagulation function in patients with laparoscopic cholecystectomy

摘要

Objective:To study the effect of general anesthesia combined with epidural anesthesia on the postoperative immune function, stress state and coagulation function in patients with laparoscopic cholecystectomy.Methods: 98 patients undergoing selective laparoscopic cholecystectomy in our hospital between May 2014 and August 2016 were selected and randomly divided into the combined anesthesia group who accepted the general anesthesia combined with epidural anesthesia and the general anesthesia group who accepted the total intravenous anesthesia (n=49), peripheral blood was collected after operation to detect the number of CD3+CD4+CD8-T cells, CD3+CD4-CD8+T cells, CD16+CD56+NK cells and CD3-CD19+B cells, serum was collected to detect the levels of stress-related endocrine hormones norepinephrine (NE), cortisol (Cor), insulin (Ins), C-peptide (C-P), free triiodothyronine (FT3), free thyroxine (FT4) as well as coagulation function indexes rostaglandin I2 (PGI2), thromboxane A2 (TXA2), 6-ketone-prostaglandin F1α (6-K-PGI1α) and thromboxane B2 (TXB2).Results:The number of CD3+CD4+CD8-T cells, CD3+CD4-CD8+T cells, CD16+CD56+NK cells and CD3-CD19+B cells in peripheral blood of combined anesthesia group were significantly higher than those of intravenous anesthesia group (P<0.05); serum NE, Cor, Ins, C-P, FT3, FT4, TXA2 and TXB2 levels of combined anesthesia group were significantly lower than those of intravenous anesthesia group (P<0.05) while PGI2 and 6-K-PGI1αlevels were significantly higher than those of intravenous anesthesia group (P<0.05).Conclusions:General anesthesia combined with epidural anesthesia can improve the postoperative immune function, stress state and hypercoagulable state in patients with laparoscopic cholecystectomy.