摘要
目的:探究不同麻醉和镇痛方法对开胸手术患者外周血免疫细胞表面抗原及受体表达的影响。方法:选取我院胸外科收治的ASAⅠ-Ⅱ级择期行开胸手术患者90例,其中A组30例,处以静脉复合麻醉,术后经静脉予以吗啡镇痛;B组30例,为静脉复合麻醉,术后经静脉曲马多镇痛;C组30例,予以静脉复合麻醉联合胸部硬膜外麻醉,术后经静脉曲马多镇痛。分别于麻醉前(T1)、术毕(T2)、术后12h(T3)、术后36h(T4)四个时间点抽取静脉血,测定外周血T淋巴细胞亚群(CD3、CD4、CD8)及淋巴细胞表面抗原(CD25)、单核细胞表面抗原(CD14)的变化。结果:13组患者在T2和T3各项指标均较T1时降低(P<0.05);但C组T2和T3降低水平较轻,与A、B组相比较有差异(P<0.05);2T4时A组处于低水平,与T1时比较无明显差异(P>0.05);T4时B组CD3、CD4、CD4/CD8、CD14和CD25明显高于A组(P<0.05);3T4时C组CD3、CD4、CD4/CD8、CD14和CD25较B组明显升高(P<0.05)。结论:经静脉曲马多镇痛抑制术后免疫细胞表面抗原和受体的表达较吗啡轻,提示曲马多更适合于术后的镇痛,对临床具有指导意义。
Objective：To explore the different folio chest surgery in patients with peripheral blood anesthesia and analgesia effects of immune cell surface antigen and the receptor expression.Methods：Department of thoracic surgery treated ASA Ⅰ-levelⅡ elective open chest surgery patient 90 cases,A group of 30 cases,with compound vein anesthesia,postoperative intravenous give morphine analgesia;Group B,30 cases of compound vein anesthesia,postoperative intravenous tramadol analgesia;C group of 30 cases,compound vein anesthesia combined thoracic epidural anesthesia and postoperative intravenous tramadol analgesia.Respectively before anesthesia（T1）,bi（T2）,12 hours after surgery（T3）,36 hours after surgery（T4）four time points extraction of venous blood,determination of peripheral blood T lymphocyte subsets（CD3,CD4,CD8）and lymphocyte surface antigens（CD25）,the change of mononuclear cell surface antigen（CD14）.Results：1Three groups of patients in various indexes decrease when the T1 T2 and T3;But to A lesser T2 and T3group C lower levels,compared with A,B group have difference;2 When the T4 at A lower level,group A compared with T1 when no significant difference（P〉0.05）;T4group B CD3,CD4,CD4/CD8,CD14 and CD25significantly higher than that in group A;3When the T4 group C CD3,CD4,CD4/CD8,CD14 and CD25increased significantly in the B group.Conclusion：Intravenous tramadol postoperative analgesia inhibiting immune cell surface antigen and the receptor expression is lighter morphine,prompt tramadol is more suitable for postoperative analgesia,to give a guidance of clinical.
出处
《陕西医学杂志》
CAS
2015年第4期394-396,共3页
Shaanxi Medical Journal
基金
浙江省医药卫生一般研究计划项目(2012KYA141)
关键词
胸廓切开术
麻醉
镇痛
免疫
细胞
Thoracotomy Anesthesia Analgesia Immunity
cellular
