地佐辛术后镇痛对结直肠癌根治术患者免疫功能的影响  

The Effects of Postoperative Analgesia with Dezocine on Immunity of Patients with Radical Resection of Colorectal Cancer

作　　者：吴晓珲[1] 岳霞影[1] 李连红[1] 

机构地区：[1]上海中医药大学附属曙光医院(东院)麻醉科,上海200021

出　　处：《湖北民族学院学报（医学版）》2013年第1期36-38,41,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察地佐辛术后镇痛对结直肠癌根治术患者免疫功能的影响,探讨结直肠癌手术合适的术后镇痛药物。方法 60例结直肠癌根治手术患者随机分为对照组和地佐辛组,均行硬膜外阻滞复合全身麻醉,术后均采用静脉自控镇痛(PCIA),两组术毕前10 min分别静脉注射吗啡0.1 mg/kg(对照组)和地佐辛0.1 mg/kg(地佐辛组),麻醉清醒后连接PICA泵,泵注药物分别为吗啡1mg/kg(对照组)和地佐辛0.8mg/kg(地佐辛组)+氟哌利多5mg,观察两组患者麻醉前、术后12h、24h和48hC-反应蛋白(CRP)和淋巴细胞亚群含量。结果与麻醉前比较,两组患者术后各时点CRP均有明显升高(P<0.05,P<0.01)。术后各时点地佐辛组CRP均明显低于对照组(P<0.05)。与麻醉前比较,对照组术后各时点CD3+、CD4+、CD4+/CD8+均明显下降(P<0.05),NK细胞术后12 h时点明显降低(P<0.05),地佐辛组术后12h时点CD3+、CD4+、CD4+/CD8+和NK细胞均明显下降(P<0.05),术后各时点地佐辛组CD3+、CD4+均明显高于对照组(P<0.05),术后12 h时点地佐辛组CD4+/CD8+和NK细胞明显高于对照组(P<0.05)。结论地佐辛用于结直肠癌患者术后镇痛可有效减少患者的免疫抑制,有利于减少患者癌细胞的扩散和促进患者术后恢复。Objective To observe the effects of postoperative analgesia with dezocine on immu- nity of patients with radical resection of colorectal cancer and probe into the analgesic drugs for postoperative colorectal cancer operation.Methods 60 cases of colorectal cancer patients were randomly divided into control group and dezocine group who would be given the general anes- thesia combined with epidural block and postoperative patient-controlled intravenous analgesia （PCIA）. Two groups were respectively given 0.1mg/kg morphine （control group） and 0.1 mg/ kg dezocine （dezocine group） by intravenous injection 10 min before operation. After recovery from anesthesia, PICA pump was connected. And then they were injected mg/kg morphine （control group）, 0.8mg/kg dezocine （dezocine group） and 5 mg droperidol by pump. And nor- mal saline was increased tol00 ml.the contents of c-reactive protein （CRP） and lymphocyte subsets in the two groups were observed before anesthesia, 12 h,24 h and 48 h after operation. Results The postoperative CRP in the two groups at all times were significantly higher （P〈0.05, P〈0.01） than before anesthesia. The postoperative CRP of the dezocine group was significantly lower than that of the control group （P〈0.05）.Compared with before anesthesia, the postoperative CD3＋,CD4＋,CD4＋/CD8＋ in the control group decreased significantly （P〈0.05）. NK cells decreased significantly ：12 h after operation （P〈0.05） and the CD3＋, CD4＋, CD4＋/CD8＋ and NK cells of dezocine group significantly decreased ：12 h after operation （P〈0.05）.The postoperative CD3＋, CD4＋ in the dezocine group were significantly higher than those in the control group （P〈 0.05） and the CD4＋/CD8＋ and NK cells in the dezocine group 12 h after operation were signifi- cantly higher than those in the control group （P〈0.05）.Conclusion The postoperative analgesia with dezocine for patients with colorectal cancer can effectively reduce the immunosuppressive effects

关 键 词：地佐辛 结直肠癌根治术 免疫功能 C-反应蛋白 

分 类 号：R735.3[医药卫生—肿瘤]