自控静脉镇痛和自控硬膜外镇痛对食管癌开胸术后应激反应、Th细胞分化以及红细胞糖代谢的影响  

Effects of self-controlled intravenous analgesia and self-controlled epidural analgesia on stress reaction,Th cells differentiation and erythrocytes glycometabolism after esophagus carcinoma thoracotomy

作　　者：周伟 赵正兰 方琴 

机构地区：[1]武汉市东西湖区人民医院麻醉科,湖北武汉430040

出　　处：《海南医学院学报》2015年第5期702-705,共4页Journal of Hainan Medical University

基　　金：武汉市卫生局临床医学科研项目(WZ09D11)~~

摘　　要：目的：研究自控静脉镇痛和自控硬膜外镇痛对食管癌开胸术后应激反应、Th细胞分化以及红细胞糖代谢的影响。方法：将2013年4月~2014年7月期间在我院接受食管癌开胸手术的120例患者纳入研究,进行术后自控镇痛,并随机分为两组,观察组患者接受自控硬膜外镇痛,对照组患者接受自控静脉镇痛,比较两组患者的术后应激反应、Th细胞分化以及红细胞糖代谢情况。结果：（1）应激反应：观察组患者的血浆皮质醇（Cor）含量低于对照组,谷胱甘肽过氧化物酶（GSH-Px）、铜-锌超氧化物歧化酶（Cu-Zn SOD）含量高于对照组（P〈0.05）;（2）Th细胞分化：观察组患者的Th1细胞含量、Th1/Th2细胞比例均高于对照组,Th2细胞含量低于对照组（P〈0.05）;（3）红细胞糖代谢：,观察组患者的血浆磷酸果糖激酶（PFK）含量高于对照组,葡萄糖-6-磷酸脱氢酶（G-6PD）、醛糖还原酶（AR）含量低于对照组（P〈0.05）。结论：自控硬膜外镇痛有助于缓解应激反应、抑制Th1/Th2细胞漂移、改善红细胞糖代谢,是食管癌开胸术后理想的镇痛方式。Objective： To study the effect of self controlled intravenous analgesia and self-controlled epidural analgesia on stress reaction, Th cells differentiation and erythroeytes glyeometabolism after esophagus carcinoma thoracotomy. Methods： A total of 120 cases of with esophagus carcinoma thoracotomy in our hospital from 2013 April to 2014 year were enrolled. They were given with postoperative self controlled analgesia and randomly divided into two groups. Patients in observation group received self-controlled epidural analgesia, control group received self controlled intravenous analgesia. Then stress reac- tion, Th cells differentiation and erythrocytes glyeometabolism were compared. Results： Plasma Cor of observation group was lower than that of control group; GSH-Px, Cu-Zn SOD were higher than those of control group. Thl cell content and Thl/ Th2 cell ratio of observation group were higher than those of control group; Th2 cells content was lower than that of control group. Plasma PFK of observation group was higher than that of control group; G-6PD and AR content were lower than those of control group. Conolusion： Self controlled epidural analgesia is helpful to relieve stress reaction, inhibit Thl/Th2 cell drift, improve red erythrocytes glycometabolism. It＇s an ideal analgesic method after esophageal cancer thoracotomy.

关 键 词：食管癌 自控静脉镇痛 自控硬膜外镇痛 应激反应 Th1/Th2细胞漂移 红细胞糖代谢 

分 类 号：R735.1[医药卫生—肿瘤]