不同剂量乌司他丁术前给药对老年腹腔镜结直肠癌根治术患者术后免疫功能及凝血因子的影响  

Comparison on the Influence of Preoperatively Administering Urinastatin at Different Doses on Their Postoperative Immuno-function and Coagulation Factors of Senior Patients Undergoing Laparoscopic Radical Surgery for Colorectal Cancer

作　　者：魏超 郑喜胜[1] WEI Chao;ZHENG Xi-sheng(The Combined ICU of Nanyang City's Central Hospital,Nanyang,Henan 473000)

机构地区：[1]南阳市中心医院综合ICU,河南南阳473000

出　　处：《中国肛肠病杂志》2022年第8期23-26,共4页Chinese Journal of Coloproctology

摘　　要：目的:探讨不同剂量乌司他丁术前给药对老年腹腔镜结直肠癌根治术患者术后免疫功能、凝血因子的影响。方法:选取2018年5月至2021年5月于我院拟行腹腔镜结直肠癌根治术的200例老年患者为研究对象,按照随机数字表法分为A、B、C、D 4组,每组50例,A、B、C组患者术前麻醉诱导前分别予0.5×10^(4) U/kg、1.0×10^(4) U/kg、1.5×10^(4) U/kg乌司他丁(均用0.9%氯化钠注射液稀释至100mL)静脉泵注,D组予等体积0.9%氯化钠注射液。比较4组患者术前(麻醉诱导前)、术后第1天和第3天的免疫功能,以及术前、术后第3天的凝血因子水平。结果:1)免疫功能指标:与术前比较,4组患者术后第1天和第3天CD8^(+)水平均无明显变化(P>0.05)。4组患者术后第1天CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均较术前明显降低(P <0.05),而术后第3天A、B、C组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)基本恢复至术前水平,D组仍低于术前水平。同时间组间比较:术后第1天和第3天,CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)A、B、C 3组均高于D组(P <0.05);A、B、C3组间比较,C组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)最高。2)凝血功能指标:与术前比较,A、B、C组患者术后第3天凝血酶时间(TT)、凝血酶原时间(PT)延长,活化部分凝血活酶时间(APTT)缩短,D组仅APTT缩短(P <0.05)。术后第3天组间比较:A、B、C组患者TT、PT、APTT均长于D组(P <0.05),A、B、C组间无明显差异(P>0.05)。结论:老年腹腔镜结直肠癌根治术患者术前应用不同剂量乌司他丁静脉泵注,均可改善其术后免疫功能及高凝状态,但1.5×104 U/kg乌司他丁改善免疫功能效果最好。Objective To investigate the influence of preoperatively administering Urinastatin at different doses on their postoperative immuno-function and coagulation factor of senior patients undergoing laparoscopic radical surgery for colorectal cancer.Methods Randomly divided 200 cases to be subject to this radical surgery in author’s hospital(2018-05—2021-05) into group A,B,C and D(50 cases,for each);before surgery they received anesthesis induction of Urinastatin,but respectively at 0.5×10^(4) U/kg(group A),1.0×10^(4) U/kg(group B) and 1.5×10^(4) U/kg(group C) by using intravenously pumprinjecting(0.9%NaCl injection diluted to 100 mL),while,in group D instead of same-volume of NaCl injection.Their immunofunction before surgery,on the 1 st day and on the 3 rd day after surgery,as well as the levels of coagulation factors on the 3 rd day after surgery were compared between the four groups.Results 1)Immunofunction norms:compared with before surgery(i.e,before anesthesis induction),in CD8^(+)level on the 1 st and 3 rd day after surgery there was no statistical difference between the four groups(P>0.05),but in the levels of CD3^(+)and CD4^(+),as well as CD4^(+)/CD8^(+)the four groups were significantly reduced on the 1 st day after surgery(P<0.05);on the 3 rd day after surgery in group A,B and C the levels of CD3^(+)and CD4^(+),as well as CD4^(+)/CD8^(+)basically turned to preoperative ones,but group D’s one still lowed than before sugery.At the same time group A,B and C’s levels of CD3^(+)and CD4^(+),as well as CD4^(+)/CD8^(+)on the 1 st and3 rd day after surgery were higher than group D’s one(P<0.05);compared between group A,B,C,the levels of CD3^(+)and CD4^(+),as well as CD4^(+)/CD8^(+)in group C were the highest.2) Coagulation function norms:compared with before surgery,among group A,B and C their TT and PT were prolonged,while APTT shortened;in group D,only APTT,shortened(P<0.05);on the 3 rd day after surgery TT,PT and APTT in group A,B and C there was no significant difference(P>0.05),but all were longer

关 键 词：结直肠癌 老年 腹腔镜手术 乌司他丁 术前给药 免疫功能 凝血因子 

分 类 号：R735.34[医药卫生—肿瘤]