舒芬太尼对食管癌手术患者细胞免疫功能及激素水平的影响  

Effect of sulfentanyl on cellular immune function and hormonal level in patient with esophagus cancer during operation

作　　者：郑振学 曹刚[2] 袁昌政 

机构地区：[1]浙江省象山县第一人民医院,315700 [2]宁波市第一医院,浙江宁波315010

出　　处：《中国医院药学杂志》2013年第11期890-893,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:研究舒芬太尼对食管癌手术患者细胞免疫功能及激素水平的影响。方法:2010年1月-2011年12月在某院择期行开胸食管癌根治术患者96例,随机分为观察组和对照组,观察组患者复合麻醉采用舒芬太尼,对照组患者采用芬太尼。2组患者分别在麻醉前(T0)、切皮时(T1)、开胸探查(T2)、拔除气管导管(T3)、术后24 h(T4)和术后48 h(T5)时抽取静脉血进行T细胞(CD4+和CD8+T淋巴细胞)和激素(生长激素、催乳素和皮质醇)水平的测定。结果:(1)T0时两组患者CD4+、CD8+和CD4+/CD8+差异无统计学意义(P>0.05),两组患者T1、T2、T3、T4和T5时CD4+和CD4+/CD8+均较T0显著降低(P<0.05或P<0.01),并且观察组患者显著高于对照组(P<0.05或P<0.01);两组患者手术前后CD8+无显著变化(P>0.05);(2)T0时两组患者GH、PRL和Cor水平差异无统计学意义(P>0.05),两组患者T1、T2、T3、T4和T5时GH、PRL和Cor水平均较T0显著升高(P<0.05或P<0.01),并且观察组患者显著低于对照组(P<0.05或P<0.01)。结论:舒芬太尼可改善食管癌患者围手术期细胞免疫功能的抑制,并降低患者围术期的激素水平,可用于食管癌围术期的复合麻醉。OBJECTIVE To compare the effect of sulfentanyl on cellular immune function and hormonal level in patients with esophagus cancer during operation. METHODS 96 patients with esophagus cancer, who received resection of carcinoma of e- sophagus in January 2010-December 2011 in our hospital, were randomly divided into observation group and control group. The patients in observation group and control group separately received combined anesthesia of sulfentanyl and fentanyl. T cells（CD4＋ and CD8＋） and hormone （grow hormone, prolactin and cortisol） were determined before anesthesia （T0）, at the mo- ment of skin cut （T1 ）, thoracotomy （T2）, tracheal extubation （T3） , 24 h after operation（T4） and 48 h after operation（T5）. RESULTS ① Level of CD4 ＋ , CD8 ＋ and CD4 ＋/CD8 ＋ in both groups was not significantly different at T0 （P〉0. 05）, and was significantly decreased at T1, T2, T3 ,T4 and T5 compared with that at T0 （P〉0. 01）. Level of CD4＋ , CD8＋ and CD4＋/CD8＋ in observation group was significantly higher than that in control group at T1, T2, T3, T4 and Ts, but level of CD8 ＋ in both groups did not significantly changed after operation （P〉0. 05）. ② Level of grow hormone, prolactin and eortisol in both groups were not significantly different at T, （P〉0. 05）, and was significantly decreased at T1, T2, T3,T4 and T5 compared with that at T0（P〉0. 01）. CD4＋ , CD8＋ and CD4＋/CD8＋ in observation group was significantly higher than that in control group at T1 , T2, T3 ,T4 and T5, but level of CD8＋ in both groups did not significantly changed after operation （P〉0. 05）. CONCLUSION Sulfentanyl can reduce the inhibition of cellular immune function,decrease hormonal level during the operation, and can be used in combined anesthesia in patients with esophagus cancer during operation.

关 键 词：舒芬太尼 食管癌 细胞免疫功能 激素水平 

分 类 号：R971.2[医药卫生—药品]