术后持续静脉镇痛对肺癌患者细胞免疫功能的影响  

Influence of Continuous Intravenous Postoperative Analgesia on the Cellular Immune Function of Patients with Lung Cancer

作　　者：段伟琴 

机构地区：[1]内蒙古自治区人民医院,010017

出　　处：《实用癌症杂志》2018年第3期475-477,共3页The Practical Journal of Cancer

摘　　要：目的探讨在肺癌患者术后持续静脉镇痛中采用右美托咪定预处理对细胞免疫功能的影响。方法选择行肺癌开胸根治术的80例患者作为研究对象。将所有患者随机分为对照组与观察组各40例。观察组在麻醉前给予右美托咪定预处理,其他同对照组。对比两组的镇痛镇静评分、手术前后的NK细胞、T淋巴细胞亚群水平及不良反应发生率。结果观察组术后24 h、48 h时间点的VAS评分均低于对照组(P<0.05);两组24 h、48 h时间点的Ramsay评分比较观察组则明显高于对照组(P<0.05)。两组在术前各T细胞亚群及NK细胞水平对比无显著性差异(P>0.05);术后1天观察组CD3+细胞、CD4+细胞、CD8+细胞、CD4+/CD8+比值及NK细胞水平显著高于对照组(P<0.05)。对照组患者共出现不良反应15例(32.5%),观察组发生不良反应4例(10.0%),观察组发生率显著低于对照(P<0.05)。此外两组均未见心动过缓、呼吸抑制等严重不良反应发生。结论在肺癌患者术后持续静脉镇痛中采用右美托咪定进行预处理,可提高镇痛效果,且对患者的细胞免疫功能抑制程度相对较轻,不良反应发生率低,有益于患者术后康复。Objective To discuss the influence of continuous intravenous postoperative analgesia on the cellular immune function of patients with lung cancer. Methods 80 cases of patients with lung cancer and treated with radical prostatectomy were selected and randomly divided into 2 groups ,40 cases in each group. Before anesthesia, the observation group was given dexmedetomidine on the basis of the control group. The analgesic sedation score, NK cell and T lymphocyte subpopulation level before and after the operation,and reverse effect rate of both groups were compared. Results The VAS scores of the observation group on 24h and 48h were lower than the control group, with P 〈 0.05. The Ramsay score of the observation group on 24h and 48h were significantly higher than the control group, with P 〈 0.05. Before operation, the T lymphocyte subpopulation level and NK cell level of both groups showed no significant difference, with P 〉 0.05. One day after operation, the CD3 ＋ cell, CD4 ＋ ceil, CD8 ＋ cell, and CD4 ＋/CD8 ＋ cell ratio, and NK cell level of the observation gronp were significantly higher than the control group, with P 〈 0.05. There were 15 cases with adverse reaction in the control group （ 32. 5% ） , while 4 cases in the observation group （ 10.0% ）. The incidence of the observation group was significantly lower than the control group, with P 〈 0.05. Besides, there were no severe adverse reactions like bradycardia and respiratory depression in both groups. Conclusion Using dexmedetomidine in the continuous intravenous postoperative analgesia for patients with lung cancer can improve the analgesic effect, with relatively lower suppression on the cellular immune function, lower adverse reaction, which is good for postoperative recovery.

关 键 词：术后持续静脉镇痛 肺癌 细胞免疫 

分 类 号：R734.2[医药卫生—肿瘤]