舒芬太尼复合艾司氯胺酮对胸腔镜肺癌根治术患者术后疼痛、免疫炎症反应和焦虑抑郁的影响  

Effects of Sufentanil Combined with Esketamine on Postoperative Pain,Immune Inflammatory Response,Anxiety and Depression in Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer

作　　者：张勤 李楠[1] 崔晓岗[1] 延育强 王贺丹 ZHANG Qin;LI Nan;CUI Xiao-gang;YAN Yu-qiang;WANG He-dan(Department of Anesthesiology,Xi'an Central Hospital,Xi'an,Shaanxi,710000,China)

机构地区：[1]西安市中心医院麻醉科,陕西西安710000

出　　处：《现代生物医学进展》2024年第22期4285-4287,4369,共4页Progress in Modern Biomedicine

基　　金：陕西省自然科学基础研究计划项目(2019JQ-576)。

摘　　要：目的:观察胸腔镜肺癌根治术患者经舒芬太尼、艾司氯胺酮复合麻醉后,患者术后免疫炎症反应、镇痛效果、焦虑抑郁的影响。方法:采用随机数字表法将120例行胸腔镜肺癌根治术患者分为对照组(60例,舒芬太尼治疗)和研究组(60例,舒芬太尼、艾司氯胺酮复合麻醉)。对比两组镇痛、镇静评分、细胞免疫功能指标、炎症因子、焦虑抑郁评分和不良反应发生率。结果:研究组术后24 h、48 h、72 h疼痛视觉模拟(VAS)评分低于对照组同时间点;Ramsay镇静评分高于对照组同时间点(P<0.05)。研究组术后24 h CD8^(+)低于对照组,CD4^(+)/CD8^(+)、CD4^(+)、CD3^(+)高于对照组,肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)低于对照组(P<0.05)。研究组术后7 d SAS、SDS评分低于对照组(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。结论:胸腔镜肺癌根治术患者经舒芬太尼、艾司氯胺酮复合麻醉后,可发挥良好的镇痛镇静效果,改善免疫功能,控制炎症反应,降低焦虑抑郁,且安全性好。Objective:To observe the effects of sufentanil and esketamine combined anesthesia on postoperative immune inflammatory response,analgesic effect,anxiety and depression in patients undergoing thoracoscopic radical resection of lung cancer.Methods:120 patients undergoing thoracoscopic radical resection of lung cancer were divided into control group(60 cases,sufentanil treatment)and study group(60 cases,sufentanil and esketamine combined anesthesia)by random number table method.Analgesia,sedation score,cellular immune function index,inflammatory factors,anxiety and depression score and incidence of adverse reactions were compared between two groups.Results:The Visual Simulation of Pain(VAS)scores in study group were lower than those in control group at the same time point 24 h,48 h and 72 h after operation.Ramsay sedation score was higher than that in control group at the same time point(P<0.05).CD8^(+)in study group was lower than that in control group 24 h after operation,CD4^(+)/CD8^(+),CD4^(+)and CD3^(+)were higher than those in control group,and tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were lower than those in control group(P<0.05).The SAS and SDS scores in study group were lower than those in control group 7 days after operation(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Patients with thoracoscopic radical resection of lung cancer after sufunthanil and esketamine,which can play a good analgesic and sedative effect,improve immune function,control inflammation,reduce anxiety and depression,and good safety.

关 键 词：艾司氯胺酮 舒芬太尼 胸腔镜肺癌根治术 镇痛效果 免疫炎症 焦虑抑郁 

分 类 号：R734.2[医药卫生—肿瘤]