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盐酸右美托咪定对肺癌患者术后镇痛效果及机体免疫功能的影响 被引量:5

The postoperative analgesic effects and influence on the immune function of dexmedetomidine hydrochloride in patients with lung cancer
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摘要 目的探讨盐酸右美托咪定在肺癌手术患者术后镇痛中的效果及对机体免疫功能的影响。方法选取148例接受胸腔镜肺癌根治术治疗患者,依据随机数字表法分为观察组和对照组,每组74例。对照组患者接受瑞芬太尼+昂丹司琼镇痛治疗,观察组患者在此基础上联合右美托咪定镇痛治疗。手术前及术后6、12、24、48 h,采用视觉模拟评分法(VAS)评估两组患者的疼痛程度;手术前后,比较两组患者T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、γ-干扰素(IFN-γ)和白细胞介素-10(IL-10)水平的变化情况。结果术后6、12、24、48 h,观察组患者的VAS评分均明显低于对照组患者,差异均有统计学意义(P﹤0.01)。手术后,观察组患者IFN-γ、CD3+、CD4+、CD8+及CD4+/CD8+水平均明显低于本组手术前,IL-10水平明显高于本组术前,且观察组患者IFN-γ水平明显低于对照组患者,IL-10、CD3+、CD4+及CD4+/CD8+水平均明显高于对照组患者,差异均有统计学意义(P﹤0.01)。两组患者恶心、呕吐、嗜睡及心动过缓等不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论盐酸右美托咪定对肺癌术后患者的镇痛效果较好,能够在一定程度上改善患者免疫功能,且不增加不良反应。 Objective To discuss the postoperative analgesic effects of dexmedetomidine hydrochloride and the influence on the immune function in patients with lung cancer.Method 148 patients with thoracoscopic radical resection of lung cancer were selected and randomly divided into observation group and control group with 74 cases in each group. The control group was given remifentanil+ondansetron for analgesia,while the observation group was additionally given dexmedetomidine hydrochloride on the basis of the regimen in control group.Before surgery and at 6,12,24 and 48 hours after surgery,the visual analogue scale (VAS) for pain was applied to evaluate the degree of pain in both groups;besides,the T lymphocyte subsets (CD3^+,CD4^+,CD8^+,CD4^+/CD8^+),γ-interferon (IFN-γ) and interleukin-10 (IL-10) level in the two groups of patients were compared before and after surgery.Result At 6,12,24 and 48 hours after operation, the VAS scores of the patients in the observation group were significantly lower than those in the control group (P<0.01). After operation,the levels of IFN-γ,CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+ in the observation group were significantly lower than those before operation,and the levels of IL-10 in the observation group were significantly higher than those in the control group,the level of IFN-γ in the observation group was significantly lower than that in the control group,besides, the levels of IL-10,CD3^+,CD4^+ and CD4^+/CD8^+ in the observation group were significantly higher than those in the control group,with statistical significance (P<0.01).There was no significant difference regarding the incidence of nausea and vomiting,somnolence,and bradycardia between the two groups (P>0.05).Conclusion Dexmedetomidine hydrochloride has affirmative analgesic effect for patients with lung cancer after surgery,and it can improve the immune function of patients without increasing the side effects.
作者 司海超 司小萌 张新科 郭培霞 刘展 马婕妤 SI Haichao;SI Xiaomeng;ZHANG Xinke;GUO Peixia;LIU Zhan;MA Jieyu(Department of Surgery,Nanyang Central Hospital,Nanyang 473000,He’nan,China;Department of Anesthesiology,Zhengzhou Central Hospital,Zhengzhou 473000,He’nan,China)
出处 《癌症进展》 2019年第7期808-811,共4页 Oncology Progress
关键词 盐酸右美托咪定 肺癌 术后镇痛 免疫功能 dexmedetomidine hydrochloride lung cancer postoperative analgesia immune function
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