右美托咪定复合依托咪酯麻醉对直肠癌术后医院感染患者免疫功能及炎性因子的影响分析  

Effect of dexmedetomidine combined with etomidate anesthesia on immune function and inflammatory factors of rectal cancer patients with postoperative nosocomial infections

作　　者：王雷[1] 牛志强[1] 郑孟良 聂宇[1] 吴水水 

机构地区：[1]河北省沧州市中心医院麻醉科,河北沧州061000

出　　处：《中华医院感染学杂志》2017年第21期4949-4952,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨右美托咪定复合依托咪酯麻醉对直肠癌术后医院感染患者免疫功能及炎性因子的影响。方法选取2015年5月-2016年5月医院行直肠癌根治术后发生医院感染患者60例,按随机数字表法将患者分为对照组与试验组,每组30名,对照组以依托咪酯麻醉进行直肠癌根治术,试验组以右美托咪定复合依托咪酯麻醉条件下进行直肠癌根治术,比较两组患者麻醉情况,医院感染发生部位,免疫功能及炎性因子变化。结果两组患者麻醉时间差异无统计学意义;试验组患者拔管时间、应答时间明显低于对照组(P<0.05);60名患者,呼吸系统感染21例,占35.00%,泌尿系统感染18例,占30.00%;两组患者手术前后IgA、IgM比较无明显差异,而患者手术后IgG水平及CD_3^+、CD_4^+、CD_8^+T细胞分数低于手术前(P<0.05);试验组术后1dIgG水平明显高于对照组,且CD_3^+、CD_4^+、CD_8^+T细胞分数在术后1d低于对照组(P<0.05);两组患者术后IL-6、TNF-α、CRP水平较术前均升高(P<0.05);但在术后即刻、术后1d、术后3d,试验组患者IL-6、TNF-α、CRP水平明显低于对照组(P<0.05)。结论行直肠癌根治术时,采用右美托咪定复合依托咪酯麻醉,可减短患者术后恢复时间,可减轻麻醉对患者机体免疫功能的影响,缓解炎性应激反应。OBJECTIVE To explore the influence of dexmedetomidine combined with etomidate anesthesia on immune function and inflammatory factors of rectal cancer patients with postoperative nosocomial infections.METHODS A total of 60 patients who received radical resection of rectal cancer and had postoperative nosocomial infections from May 2015 to May 2016 were enrolled in the study and randomly divided into the control group and the observation group,with 30 cases in each group.The control group was treated with etomidate anesthesia for the radical resection of rectal cancer,while the observation group was given dexmedetomidine combined with etomidate anesthesia for the radical resection of rectal cancer.The anesthesia status,nosocomial infection sites,immune function and inflammatory factors were observed and compared between the two groups of patients.RESULTS There was no significant difference in the anesthesia time between the two groups of patients;the extubation time and response time of the observation group were significantly shorter than those of the control group（P〈0.05）.Among 60 patients,21（35.00%）had respiratory system infections,18（30.00%）had urinary system infections.There was no significant difference in the IgA or IgM between the two groups of patients before and after the surgery,however,the IgG level and CD3^＋,CD4^＋and CD8＋T cell fractions of the patients were lower after the surgery than before the surgery（P〈0.05）;the IgG level of the observation group was significantly higher than that of the control group after the surgery for 1 day,and the CD3^＋,CD4^＋and CD8＋T cell fractions of the observation group were significantly lower than those of the control group after the surgery for 1 day（P〈0.05）.The levels of IL-6,TNF-αand CRP of the two groups of patients were significantly higher after the surgery than before the surgery（P〈0.05）,however,the levels of IL-6,TNF-αand CRP of the observation group were significantly lower than those of the control group instantly

关 键 词：右美托咪定 依托咪酯 直肠癌 医院感染 免疫功能 炎性因子 

分 类 号：R978.1[医药卫生—药品]