中国妇幼健康研究2026，Vol.37Issue(6)：74-79,6.DOI:10.3969/j.issn.1673-5293.2026.06.010
艾司氯胺酮对经腹全子宫切除术患者免疫功能、应激反应、血流动力学的影响
Effects of esketamine on the immune function,stress response and hemodynamics in patients undergoing total abdominal hysterectomy
摘要
Abstract
Objective To investigate the anesthetic effects of esketamine combined with etomidate-based transversus abdominis plane block(TAPB)in patients undergoing total abdominal hysterectomy.Methods A total of 120 patients who underwent total abdominal hysterectomy at The First Hospital of Qiqihar from May 2021 to May 2024 were enrolled and randomly divided into a reference group and a study group,with 60 patients in each group.The reference group received TAPB combined with etomidate anesthesia,while the study group received TAPB combined with etomidate and esketamine anesthesia.Perioperative indicators,immune function,stress response,hemodynamic parameters,postoperative pain,and adverse reactions were compared between the two groups.Results Compared with the reference group,the study group showed significantly shorter extubation time,post-anesthesia care unit stay time,and fewer presses of the analgesia pump(t=13.165,5.074,and 23.229,respectively,P<0.05).Postoperatively,levels of CD3+,CD4+,and CD4+/CD8+in the study group were significantly higher than those in the reference group,whereas levels of dopamine(DA)and norepinephrine(NE)were significantly lower(t values ranging from 2.750 to 8.273,P<0.05).Significant main effects of time and group,as well as significant interaction effects,were observed for heart rate(HR)and mean arterial pressure(MAP)(Finteraction=2.744 and 4.149,respectively,P<0.05).Further analysis demonstrated that HR and MAP levels at T1(during intubation)and T2(30 min after the beginning of surgery)were significantly lower in the study group than in the reference group(P<0.05).Significant main effects of time and group were also observed for numerical rating scale(NRS)scores after surgery,whereas no interaction effect was identified(Finteraction=2.212,P>0.05).Further analysis showed that NRS scores at 6 h,12 h,and 24 h postoperatively were significantly lower in the study group than in the reference group(P<0.05).No statistically significant differences were found between the two groups in the incidence of adverse reactions,such as pruritus and respiratory forgetfulness(P>0.05).Conclusion Compared with etomidate-based TAPB anesthesia alone,esketamine combined with etomidate anesthesia in patients undergoing total abdominal hysterectomy can effectively alleviate postoperative pain and reduce immune injury,demonstrating favorable efficacy and high clinical application value.关键词
全子宫切除术/艾司氯胺酮/免疫功能/血流动力学/应激反应Key words
total abdominal hysterectomy/esketamine/immune function/hemodynamics/stress response分类
医药卫生引用本文复制引用
祁晓勇,王洪生,陶钧龙,张鑫..艾司氯胺酮对经腹全子宫切除术患者免疫功能、应激反应、血流动力学的影响[J].中国妇幼健康研究,2026,37(6):74-79,6.基金项目
齐齐哈尔市科技计划创新激励项目(CSFGG-2024042) （CSFGG-2024042）
