右美托咪定与氟比洛芬酯联合应用对胃癌患者术后镇痛及细胞免疫功能的影响  

Effects of dexmedetomidine combined with flurbiprofen axetil on postoperative analgesia and cellular immune function in patients with gastric cancer

作　　者：刘芳芳 刘松涛[1] 周海[1] 李娜[1] Liu Fangfang;Liu Songtao;Zhou Hai;Li Na(Anesthesia Department of Xuzhou Center Hospital,Xuzhou 221000,China)

机构地区：[1]江苏省徐州市中心医院麻醉科

出　　处：《广西医科大学学报》2019年第12期1981-1985,共5页Journal of Guangxi Medical University

摘　　要：目的:探讨右美托咪定、氟比洛芬酯联合应用对胃癌患者术后镇痛效果、安全性及细胞免疫功能的影响。方法:选取2017年4月至2018年6月在江苏省徐州市中心医院择期行胃癌根治术治疗的76例胃癌患者,按随机数字表法分为观察组和对照组,每组38例。对照组在麻醉诱导前使用氟比洛芬酯,观察组超前给予氟比洛芬酯及右美托咪定,分析患者术中应激反应、术后镇痛效果、细胞免疫功能等情况。结果:观察组插管时、拔管时平均动脉压(MAP)及心率(HR)均显著低于对照组(均P<0.05);与对照组比较,观察组术后即刻、12 h、24 h、48 h的视觉模拟量表(VAS)评分均显著降低,术后即刻、12 h的舒适度(BCS)评分及术后1 d、5 d的CD3^+、CD4^+、CD4^+/CD8^+均显著升高(均P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定联合氟比洛芬酯超前麻醉方案用于胃癌根治术可取得显著镇痛效果,使患者术中应激反应及术后疼痛明显减轻,且能较好地调节细胞免疫功能。Objective:To evaluate the effects of metomidine and flurbiprofen axetil on postoperative analgesia,safety and cellular immune function in patients with gastric cancer.Methods:76 patients with gastric cancer who underwent elective radical gastrectomy in our hospital from April 2017 to June 2018 were selected,and randomly divided into a control group and an observation group,with 38 cases in each group.The patients in the control group received flurbiprofen axetil before induction of anesthesia,and those in the observation group received flurbiprofen axetil and dexmedetomidine in advance.The stress response,analgesic effect and cellular immune function were analyzed.Results:The mean arterial pressure(MAP)and heart rate(HR)during intubation and extubation in the observation group were significantly lower than those in the control group(P<0.05).Compared with the control group,the visual analogue scale(VAS)score was significantly decreased in the observation group immediately after operation and 12 h,24 h and 48 h post-operation,while the comfort(BCS)score immediately after operation and 12 h post-operation as well as the CD3^+,CD4^+and CD4^+/CD8^+on day 1 and 5 post-operation were significantly increased(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dexmedetomidine combined with flurbiprofen axetil can achieve significant analgesic effect in radical gastrectomy,reduce intraoperative stress response and postoperative pain,and better regulate cellular immune function.

关 键 词：胃癌根治术 麻醉 氟比洛芬酯 右美托咪定 镇痛 免疫功能 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]