地佐辛复合舒芬太尼术后自控静脉镇痛对老年甲状腺癌患者细胞免疫功能的影响研究  

The Postoperative Patient-controlled Intravenous Analgesia with Dezocine and Sufentanil on the Cellular Immune Function for Elderly Thyroid Cancer Patients

作　　者：刘明 朱新建 张浩[2] 姜开洋[1] 郭满[3] LIU Ming;ZHU Xinjian;ZHANG Hao;JIANG Kaiyang;GUO Man(Department of Pain,Nanyang Central Hospital,Nanyang Henan 473000,China;Department of Breast Surgery,Nanyang Central Hospital,Nanyang Henan 473000,China;Department of Thyroid Surgery,Nanyang Central Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市中心医院疼痛科,河南南阳473000 [2]南阳市中心医院乳腺外科,河南南阳473000 [3]南阳市中心医院甲状腺外科,河南南阳473000

出　　处：《临床研究》2023年第11期43-46,共4页Clinical Research

摘　　要：目的 分析术后自控静脉镇痛期间采取地佐辛加舒芬太尼对甲状腺癌老年患者细胞免疫功能的影响。方法 选取2021年1月至2022年12月南阳市中心医院收治的甲状腺癌老年患者总共86例进行研究,经随机数表法分成对照组(舒芬太尼加托烷司琼)和观察组(地佐辛加舒芬太尼)各43例,观察两组术后不同时间点的视觉模拟量表(VAS)及Ramsay镇静得分,术后下床、住院时间以及24 h内舒芬太尼用量,麻醉前和术后24 h的CD4^(+)、CD8^(+)、CD3^(+)细胞数及CD4^(+)/CD8^(+)水平及不良反应情况。结果 两组术后2 h、6 h、12 h、24 h、48 h的VAS得分相比,差异无统计学意义(P>0.05)。观察组术后2 h、6 h、12 h、24 h、48 h的Ramsay镇静得分均高于对照组,差异有统计学意义(P<0.05)。观察组术后下床、住院时间短于对照组,差异有统计学意义(P<0.05),24 h内舒芬太尼用量少于对照组,差异有统计学意义(P<0.05)。麻醉前,两组CD4^(+)、CD8^(+)、CD3^(+)、CD4^(+)/CD8^(+)水平相比,差异无统计学意义(P>0.05);术后24 h,两组CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)水平均较前降低,CD8^(+)水平均较前升高,且观察组CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)水平高于对照组,差异有统计学意义(P<0.05),两组CD8^(+)水平相比,差异无统计学意义(P>0.05)。观察组不良反应率(6.98%)低于对照组(23.26%),差异有统计学意义(P<0.05)。结论 甲状腺癌老年患者术后自控静脉镇痛期间采取地佐辛加舒芬太尼效果理想,能减轻免疫抑制,促进其术后恢复,减少舒芬太尼用量及不良反应出现,值得采用。Objective To analyze the impacts of postoperative patient-controlled intravenous analgesia with Dezocine and Sufentanil on the cellular immune function for elderly thyroid cancer patients.Methods 86 elderly thyroid cancer patients treated from January 2021 to December 2022 in our hospital were investigated.According to random number table,patients were assigned to control group (n=43,Sufentanil and tropisetron) and observation group (n=43,Dezocine and Sufentanil).Analgesia effects were evaluated through the visual analogue scale (VAS) and Ramsay scores at the different time points,the ambulant time,the hospital stays,24-hour Sufentanil use dosage,CD4^(+),CD8^(+),CD3^(+)and CD4^(+)/CD8^(+)levels before anesthesia and after24h of surgery,the adverse reactions.Results After 2 h,6 h,12 h,24 h and 48 h of surgery,VAS scores between groups were not significantly different (P>0.05);after 2 h,6 h,12 h,24 h and 48 h of surgery,Ramsay scores in the observation group were significantly higher than control group (P<0.05);the ambulant time and hospital stays in the observation group were significantly shorter than control group (P<0.05);24-hour Sufentanil use dosage in the observation group was significantly lower than control group (P<0.05);before anesthesia,CD4^(+),CD8^(+),CD3^(+)and CD4^(+)/CD8^(+)levels between groups were not significantly different (P>0.05);after 24h of surgery,CD4^(+),CD3^(+),and CD4^(+)/CD8^(+)levels for two groups were lower than before (P<0.05);CD8^(+)levels for two groups were higher than before (P<0.05);CD4^(+),CD3^(+)and CD4^(+)/CD8^(+)levels in the observation group were even higher than control group (P<0.05);CD8^(+)levels between groups were not significantly different(P>0.05);the adverse event rates in the observation group were significantly lower than control group (P<0.05).Conclusion The postoperative patient-controlled intravenous analgesia with Dezocine and Sufentanil can effectively relieve the immunological suppression,promote the postoperative rehabilitation,reduce the Sufentanil use

关 键 词：自控静脉镇痛 地佐辛 舒芬太尼 甲状腺癌 免疫功能 

分 类 号：R335[医药卫生—人体生理学]