全身麻醉及手术期间和术后的中性粒细胞趋化作用。

Neutrophil chemotaxis during and after general anesthesia and operation.

作者信息

Stanley T H, Hill G E, Portas M R, Hogan N A, Hill H R

出版信息

Anesth Analg. 1976 Sep-Oct;55(5):668-73.

Abstract

The neutrophil granulocytes of 43 patients undergoing general anesthesia and operation were examined to determine if altered function occurs during these procedures. Neutrophil chemotaxis, random migration, and total and differential leukocyte counts were determined immediately before anesthesia; after 35 to 60 minutes of anesthesia but before operation; 60 minutes after initiation of operation; and 60 minutes after operation. Anesthetic agents included 1 to 3.5% enflurane, 0.5 to 2% halothane, or 0.5 to 1.1 mg/kg of morphine plus N2O-O2 (60:40). Neutrophil and total white blood cell counts were uninfluenced by any of the anesthetics; however, marked rises in both occurred during operation and persisted postoperatively after each of the anesthetic technics. Neutrophil chemotaxis was reduced an average of 36, 32, and 21%, respectively, by halothane, enflurane, and morphine before operation and 20, 10, and 5% intraoperatively. Preoperative reductions in chemotaxis were statistically significant after all anesthetics. However, only halothane produced a significant intraoperative reduction in chemotaxis. Postoperative neutrophil chemotaxis did not differ from control (preanesthesia) values after any of the anesthetics. Halothane and enflurane reduced leukocytic random migration before but not after operation. Morphine had no effect on random migration at any time. These data demonstrate that anesthesia impairs neutrophil function in man but that operation appears to reverse this depression.

摘要

对43例接受全身麻醉和手术的患者的中性粒细胞进行检查，以确定在这些操作过程中其功能是否发生改变。在麻醉前、麻醉35至60分钟但手术前、手术开始后60分钟以及手术后60分钟，分别测定中性粒细胞趋化性、随机游走以及白细胞总数和分类计数。麻醉剂包括1%至3.5%的恩氟烷、0.5%至2%的氟烷，或0.5至1.1mg/kg的吗啡加N2O - O2（60:40）。中性粒细胞和白细胞总数不受任何一种麻醉剂的影响；然而，在手术期间两者均显著升高，并且在每种麻醉技术后的术后仍持续升高。术前，氟烷、恩氟烷和吗啡分别使中性粒细胞趋化性平均降低36%、32%和21%，术中降低20%、10%和5%。所有麻醉剂使用后，术前趋化性的降低均具有统计学意义。然而，只有氟烷在术中使趋化性产生显著降低。任何一种麻醉剂使用后，术后中性粒细胞趋化性与对照（麻醉前）值无差异。氟烷和恩氟烷在手术前降低白细胞随机游走，但手术后未降低。吗啡在任何时候对随机游走均无影响。这些数据表明，麻醉会损害人体中性粒细胞功能，但手术似乎可逆转这种抑制作用。