摘要
目的:观察地佐辛复合舒芬太尼术后自控静脉镇痛对肿瘤患者T淋巴细胞亚群和NK细胞水平的影响。方法:择期行胃肠道恶性肿瘤根治术患者40例,将其随机分为地佐辛复合舒芬太尼组(DS组,n=20)和舒芬太尼组(S组,n=20)。两组患者术后各时点采用视觉模拟评分(VAS评分)行镇痛效果评价;分别于麻醉前(T0)、术毕(T1)、术后12h(T2)、24h(T3)、48h(T4)抽取外周静脉血,用流式细胞仪测定其T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)及NK细胞水平。结果:两组患者各时点VAS评分差异无统计学意义;与T0时比较,T1～T4时两组患者CD3+、CD4+、CD4+/CD8+水平均明显降低(P<0.05),T1～T3时两组患者NK细胞水平低于麻醉前(P<0.05)。两组各时点CD8+水平变化差异无统计学意义。与S组相比,DS组在术后24 h CD3+、CD4+、CD4+/CD8+、NK细胞水平明显增高(P<0.05);术后48hDS组NK细胞水平已恢复到麻醉前水平,而S组仍处于较低水平(P<0.05)。结论:地佐辛复合舒芬太尼自控静脉镇痛更有利于肿瘤患者术后细胞免疫功能的恢复。
Objective To investigate the effects of postoperative patient controlled intravenous analgesia （PCIA） with dezoeine combined with sufentanil on T-lymphocyte subsets and natural killer （NK） cells in patients with tumor. Methods 40 patients undergoing selective radical operation for gastroenteric tumor were randomly divided into dezocine combined with sufentanil group （Group DS, n = 20） and snfentanil group （Group S, n = 20）. The analgesic effects were estimated by visual analog scale （VAS） in different time point after operation. Blood samples were collected before anesthesia （To）, the end of operation （Tl）, and 12 h （T2）, 24 h （T3）, 48 h （T4） after surgery for the determination of T-lymphocyte subsets （CD3＋, CD4＋, CD8＋, CD4＋/CD8＋） and NK cells using flow cytometry. Results There were no statistical differences in VAS at any time point between the two groups. Compared with To, the levels of CD3＋, CD4＋, CD4＋/CD8＋ were decreased significantly at TrT4 in the two groups （P 〈 0.05）. The amounts of NK cells were increased significantly at T＋-T3 （P 〈 0.05）. There was no significant difference with regard to CD8＋ lymphocytes between the two groups. Compared with Group S, the levels of CD3＋, CD4＋, CD4＋/CD8＊, and NK cells in Group DS were increased significantly at 24 h after surgery （P 〈 0.05）. In Group DS, the level of NK cells were recovered to baseline value at 48 h after surgery, while in Group S, it was still lower than baseline value （P 〈 0.05）. Conclusion PCIA with dezocine combined with sufentanil was more beneficial to recover the cell-immunity of patients with gastroenterie tumor after surgery.
出处
《实用医学杂志》
CAS
北大核心
2013年第6期982-984,共3页
The Journal of Practical Medicine
基金
河北省衡水市科学技术研究与发展计划项目(编号:12010A)
关键词
地佐辛
舒芬太尼
自控静脉镇痛
胃肠道肿瘤
T淋巴细胞亚群
NK细胞
Dezocine
Sufentanil
Patient controlled intravenous analgesia
Gastroenteric tumor
T-lymphocyte subsets
Natural killer cells
