羟考酮联合右美托咪定对全身麻醉乳腺癌根治术患者免疫功能的影响  

Effects of Oxycodone Combined with Dexmedetomidine on Immune Function of Patients Undergoing Radical Mastectomy with General Anesthesia

作　　者：白延斌[1] 陈彬[1] 张海亮[1] 陈锴[1] 闫照虹 BAI Yanbin;CHEN Bin;ZHANG Hailiang;CHEN Kai;YAN Zhaohong(The Affiliated Hospital of Yan'an University,Yan'an,Shaanxi,716000,China;Anesthesiology Department,Tangdu Hospital,Air Force Medical University,Xi'an,Shaanxi,710038,China)

机构地区：[1]延安大学附属医院,陕西延安716000 [2]空军军医大学唐都医院麻醉科,陕西西安710038

出　　处：《肿瘤药学》2020年第4期461-466,共6页Anti-Tumor Pharmacy

基　　金：陕西省自然科学基础研究计划(2018JM7067)。

摘　　要：目的探究羟考酮联合右美托咪定对全身麻醉下行乳腺癌根治术患者免疫功能的影响。方法选择2013年8月—2018年8月于我院确诊并接受乳腺癌根治术的患者300例为研究对象,随机分为3组,各100例,分别为羟考酮组、右美托咪定组、羟考酮联合右美托咪定组(联合组)。观察并比较三组患者手术时间、麻醉时间、出血量等一般情况以及术后12、24、48 h疼痛VAS评分。分别检测三组患者术前12 h和术后12、24 h免疫细胞CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞水平和抗炎因子IL-2、IL-8、IL-10水平。结果术后12、24、48 h,联合组患者VAS评分均显著低于其余两组(P<0.05)。术后12 h,三组患者CD3+、CD4+、CD4+/CD8+、NK细胞水平均显著降低(P<0.05),且联合组高于其余两组;三组CD8+水平均显著上升(P<0.05),且联合组低于其余两组。术后24 h,三组患者CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞水平比较均无明显差异(P>0.05)。术后12、24 h,三组患者IL-2、IL-8水平均显著降低,且联合组显著高于其余两组(P<0.05);IL-10水平均显著上升,且联合组显著低于其余两组(P<0.05)。结论羟考酮和小剂量右美托咪定联合用于接受全身麻醉乳腺癌根治术患者的静脉自控镇痛,有利于术后机体免疫功能的改善,值得临床推广。Objective To investigate the effects of oxycodone combined with dexmedetomidine on the immune function of patients undergoing radical mastectomy with general anesthesia.Methods A total of 300 patients who were diagnosed with breast cancer and accepted radical mastectomy in our hospital were enrolled in this study.They were randomly divided into three groups:oxycodone group,dexmedetomidine group,oxycodone+dexmedetomidine group(combination group),100 cases in each group.Observe and compare the operation time,anesthesia time,blood loss and other general conditions.Record the VAS scores at 12,24,48 h after operation.Detect the levels of CD3+,CD4+,CD8+and NK cells,and CD4+/CD8+,as well as the levels of IL-2,IL-8 and IL-10 at 12 h before and 12 h,24 h after operation.Results At 12,24,48 h after radical mastectomy,the VAS score was significantly lower in the combination group than in the other two groups(P<0.05).At 12 h after operation,the levels of CD3+,CD4+,NK cells and the CD4+/CD8+decreased significantly in the three groups,but they were still higher in the combination group than in the other two groups(P<0.05).The CD8+level increased significantly in the three groups,but was still lower in the combination group than in the other two groups(P<0.05).At 24 h after operation,there were no significant differences in CD3+,CD4+,CD8+,NK cell levels and CD4+/CD8+between the three groups(P>0.05).At 12,24 h after operation,the levels of IL-2 and IL-8 were significantly decreased in the three groups,but they were still higher in the combination group than in the other two groups(P<0.05).In addition,the IL-10 level was significantly increased in three groups,but was still lower in the combination group than in the other two groups(P<0.05).Conclu-sion Oxycodone combined with low-dose dexmedetomidine for intravenous analgesia in patients undergoing radical mastectomy with general anesthesia is beneficial to the improvement of postoperative immune function and is worthy of clinical promotion.

关 键 词：羟考酮 右美托咪定 乳腺癌根治术 免疫功能 

分 类 号：R737.9[医药卫生—肿瘤]