摘要
目的:探讨不同麻醉及镇痛方法对宫颈癌患者细胞免疫功能和术后恢复的影响。方法:拟行腹腔镜下宫颈癌根治术患者78例,分为3组(n=26),Ⅰ组:全凭静脉麻醉+静脉病人自控镇痛(PCIA),Ⅱ组:全凭静脉麻醉联合硬膜外神经阻滞+硬膜外病人自控镇痛(PCEA),Ⅲ组:静吸复合麻醉联合硬膜外神经阻滞+PCEA。观察麻醉前(T_0)、术毕(T_1)、术后24h(T_2)、术后48 h(T_3)时点T淋巴细胞亚群及NK细胞百分比的变化。记录患者第一次补救镇痛时间、胃肠道恢复时间、下床时间、术后呕吐及患者满意度。结果:与T_0比较,3组患者在T_1、T_2时点CD3^+、CD4^+、CD4^+/CD8^+及NK细胞百分比明显降低,CD8^+明显升高(P<0.05);Ⅱ组和Ⅲ组在T_2及T_3与Ⅰ组比较,CD3^+、CD4^+、CD4^+/CD8^+及NK细胞百分比显著增高,CD8^+细胞百分比显著降低(P<0.05)。Ⅱ组和Ⅲ组患者术后恢复明显优于Ⅰ组(P<0.05),其中术后呕吐和患者满意度Ⅱ组明显优于Ⅲ组(P<0.05)。结论:全凭静脉麻醉联合硬膜外神经阻滞并行硬膜外术后镇痛对宫颈癌患者术后细胞免疫功能的抑制较小,术后恢复快,有益于患者的康复。
Objective：To investigate the effscts of different anesthetic and postoperative analgesic methods on cellular immune function and postoperative recovery in patients with cervical cancer.Methods：Seventy-eight patients scheduled for laparoscopic radical hysterectomy were randomly divided into 3 groups（26 in each group） ：GroupⅠ：Total intravenous anesthesia with patient-controlled intravenous analgesia（ PCIA）,group Ⅱ：Epidural combined intravenous anesthesia with PCEA and groupⅢ：Epidural combined intravenous-inhalational anesthesia with patient-controlled epidural analgesia（PCEA）.The change of T-lymphocyte subsets and NK cells were observated at before anesthesia（T0）,the end of operation（T1）,24 hours after operation（T2） and 48 hours after operation（T3） time point.First remedy analgesic time,gastrointestinal recovery time,postoperative activity time,postoperative vomiting and satisfaction of patients were recorded.Results：Compared with T0,the percentage of CD3^＋,CD4^＋,NK cells and CD4^＋/CD8^＋were significantly decreased and the percentage of CD8^＋ cells was significantly increased at T1 and T2 in all groups（P〈0.05）.Compared with groupⅠ,the percentage of CD3^＋）,CD4^＋,NK cells and CD4^＋/CD8^＋were significantly increased and the percentage of CD8^＋cells was significantly decreased at T2,T3 in groupⅡand groupⅢ（ P〈0.05）.Postoperative recovery in groupⅡand group Ⅲ was better than groupⅠ（P〈0.05）.Conclusion：Intravenous anesthesia with epidural anesthesia and postoperative epidural analgesia for patients with cervical cancer,has quick recovery after operation.
作者
周彪
王琛
韩国瑞
吕梦新
刘涛
Zhou Biao;Wang Chen;Han Guorui;Lv Mengxin;Liu Tao(Department of Anaesthesiology;Central Laboratory,Luoyang Central Hospital Affiliated to Zhengzhou University,Henan Luoyang 471009,China.)
出处
《现代肿瘤医学》
CAS
2018年第11期1777-1780,共4页
Journal of Modern Oncology
关键词
麻醉
术后镇痛
宫颈癌
细胞免疫功能
anesthesia
postoperative analgesia
cervical cancer
cellular immune function
