盐酸氢吗啡酮联合枸橼酸舒芬太尼对肺癌患者的临床疗效及免疫功能的影响  

Clinical Efficacy and Immune Function of Hydromorphone Hydrochloride Combined with Sufentanil Citrate in Patients with Lung Cancer

作　　者：杨志军[1] 黄佳洋[1] 熊浪 严国胜[1] YANG Zhijun;HUANG Jiayang;XIONG Lang(Ezhou Central Hospital,Ezhou,436000)

机构地区：[1]湖北省鄂州市中心医院,436000

出　　处：《实用癌症杂志》2019年第5期778-781,共4页The Practical Journal of Cancer

摘　　要：目的探讨盐酸氢吗啡酮联合枸橼酸舒芬太尼对肺癌患者的临床疗效及免疫功能的影响。方法选择115例择期接受手术治疗的肺癌患者作为研究对象,随机将其分为对照组与观察组,对照组患者采取枸橼酸舒芬太尼进行麻醉,观察组则在对照组的基础上联合盐酸氢吗啡酮进行麻醉,对两组患者在不同时间的平均动脉压、心率、去甲肾上腺素、肾上腺素、血糖以及皮质醇进行比较分析,同时比较两组患者的睁眼,拔管时间,疼痛程度以及免疫功能。结果与对照组相比,观察组患者在各时间点的HR与MAP均明显降低,在插管前与插管后1 min时差异具有显著性,在插管后5 min与10 min时则与对照组形成极显著性差异;血清指标结果表明与插管前相比,对照组与观察组均在插管后1min与5 min出现显著上升,但观察组明显低于对照组,差异具有统计学意义,但在插管后10 min各组指标均出现下降,无显著性差异;两组患者术后的睁眼时间与拔管时间无统计学差异;而观察组患者在术后以及术后12 h的VAS评分均显著低于对照组,经统计学分析,差异具有显著性,免疫功能结果表明两组患者治疗前CD3^+、CD4^+、CD8^+与CD4^+/CD8^+水平无显著性差异,在术后24 h时各指标均有所下降,且观察组下降幅度显著低于对照组,差异具有统计学意义;在经过一周治疗后,两组患者的CD4^+与CD8^+指标无明显差异。结论盐酸氢吗啡酮联合枸橼酸舒芬太尼可显著降低免疫抑制与呼吸抑制,减轻血流动力学波动,提高镇痛效果,值得临床推广。Objective To investigate clinical efficacy and immune function of hydromorphone hydrochloride combined with sufentanil citrate in patients with lung cancer. Methods A total of 115 lung cancer patients undergoing elective surgery were selected as study subjects. They were randomly divided into control group and observation group. Patients in the control group received sufentanil citrate for anesthesia,the observation group was anesthetized with hydromorphone hydrochloride on the basis of the control group. The mean arterial pressure,heart rate,norepinephrine,epinephrine,blood glucose,and cortisol were compared between the two groups at different times. At the same time,eye blinking,extubation time,pain level,and immune function were compared between the two groups. Results Compared with the control group,HR and MAP of the observation group at each time point were significantly reduced,and the difference was significant between before intubation and 1 min after intubation. After 5 minutes and 10 minutes of intubation,there was a significant difference with the control group. Serum indicator results showed that compared with pre-intubation,both the control group and the observation group showed a significant increase at 1 and 5 minutes after intubation,but the observation group was significantly lower than the control group,and the difference was statistically significant,however,after 10 minutes of intubation,the indexes of all groups showed a decrease,with no significant difference. There was no statistical difference between the time of eyelid opening and the time of extubation between the two groups. In the observation group,the VAS scores were significantly lower in the postoperative and 12 h postoperative groups than in the control group,statistical analysis showed that the difference was significant;The results of immune function showed that there was no significant difference in the levels of CD3^+,CD4^+,CD8^+,and CD4^+/CD8^+before treatment between the two groups. At 24 h after surgery,all indexes decreased

关 键 词：盐酸氢吗啡酮 枸橼酸舒芬太尼 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]