右美托咪啶复合舒芬太尼用于食道癌术后镇痛对机体免疫细胞的影响  

Effects of Dexmedetomidine Combined with Sufentanil on Immune Cells in Postoperative Analgesia of Esophageal Cancer Patients

作　　者：冉茂荣[1] 林露[1] 牛洁[1] 龚华渠[1] 

机构地区：[1]成都军区总医院麻醉科,四川成都610083

出　　处：《四川医学》2017年第9期1043-1045,共3页Sichuan Medical Journal

摘　　要：目的探讨右美托咪啶复合舒芬太尼PCIA用于食道癌手术术后镇痛对机体免疫细胞的影响。方法选择食道癌根治术患者132例,随机分为复合组(A组)与舒芬太尼组(B组)。PCIA给药方案;A组:右美托咪啶1μg/kg,舒芬太尼2μg/kg,托烷司琼10mg;B组舒芬太尼2μg/kg,托烷司琼10mg。分别用于麻醉诱导前(T_0)、气管导管拔除即刻(T_1)、术后12h(T_2)、术后24h(T_3)、术后48h(T_4)、术后72h(T_5),对外周血管中CD_(3+)、CD_(4+)、CD_(8+)淋巴细胞亚群及NK细胞含量进行检测,并计算CD_(4+)/CD_(8+)值,并观察术后不良反应发生情况。结果 A组患者术后T_2-T_5时不良反应发生率明显低于B组,差异有统计学意义(P<0.05);与T_0时比较,两组患者T_1-T_5时CD_(3+)、CD_(4+)、CD_(4+)/CD_(8+)和NK细胞水平均降低。A组患者T_2-T_5时CD_(3+)水平和CD_(4+)/CD_(8+)均明显高于B组,A组T_3-T_5时,CD_(4+)和NK细胞水平明显高于B组,差异有统计学意义(P<0.05)。结论右美托咪啶复合舒芬太尼PCIA用于食管癌术后镇痛可降低镇痛时不良反应的发生,改善患者细胞免疫功能,有利于患者预后。Objective To investigate the effect of dexmedetomidine combined with sufentanil PCIA on immune cellsin postoperative analgesia of esophageal cancer patients. Methods 132 patients with esophageal cancer radical calcification were randomly divided into two groups ： combination group （ group A） and sufentanil group （ group B ）. PCIA dosing regimen, Group A ： dexmedetomidine 1 μg/kg, sufentanil 2 μg/kg, tropisetron 10rag; Group B ： sufentanil 2 μg/kg, tropisetron 10mg. Administration time werebefore anesthesia induction （ T0）, tracheal tube extraction immediately （ T1 ）, postoperative 12h （ T2 ）, postoperative 24h （ T3 ）, postoperative 48h（T4）,postoperative 72h （TS）. Peripheral blood vessels CD3＋, CD4＋, CDs＋ lymphocyte subsets and NK cells were measured and the CIM ＋/CD8 ＋ ratio was calculated. The incidence of adverse reactions was observed. Results The inci- dence of adverse events was significantly lower in group A （ T2-T5 ） than that in group B （ P 〈 0. 05 ）. Compared with TO, the levels of CD3 ＋ , CD4 ＋ , CD4＋/CD8＋ and NK cells were reduced （T1-T5） in both groups. The levels of CD3＋ and CD4＋/CD s . in group A were significantly higher than those in group B （T2-T5）. And the levels of CD4＋ and NK cells in group A were significantly higher than those in group B （T3-T5） （P 〈 0. 05 ）. Conclusion Dextemethamine combined with sufentanil PCIA for postoperative analgesia in esophageal cancer can reduce the incidence of adverse reactions during analgesia and improve the cellular immune function of patients, which is beneficial to the prognosis of patients.

关 键 词：食管癌 右美托咪啶 免疫细胞 

分 类 号：R614[医药卫生—麻醉学] R735.1[医药卫生—外科学]