右美托咪定复合吗啡PCIA用于开胸手术术后镇痛对机体免疫细胞的影响

发布时间：2018-10-24 22:57

【摘要】：目的探讨右美托咪定复合吗啡PCIA用于开胸手术术后镇痛对机体免疫细胞的影响。方法选择2012年3月至2014年4月在我院行开胸手术的患者112例,男53例,女59例,年龄41~60岁,ASAⅠ或Ⅱ级,随机分为复合组和吗啡组,其中,复合组51例,男26例,女25例,吗啡组61例,男27例,女34例,术毕苏醒、气管导管拔除后,主诉疼痛者(VAS评分4分)行PCIA。PCIA给药方案:复合组患者给予含1.0μg/kg右美托咪定和0.48mg/kg吗啡的药液150ml,吗啡组患者则给予含0.48mg/kg吗啡的药液150 ml,负荷量2 ml,背景输注速率2 ml/h,锁定时间15min,维持术后疼痛VAS评分≤3分。分别于麻醉诱导前(T0)、气管导管拔除即刻(T1)、术后12h(T2)、术后24h(T3)、术后48h(T4)、术后72h(T5)及术后7d(T6),利用FACSCalibur流式细胞仪对外周血中CD3+、CD4+、CD8+淋巴细胞亚群及NK细胞含量进行检测,并计算CD4+/CD8+值,记录T3~T5时的吗啡用量,术后7d患者不良反应发生情况。结果复合组患者术后T2~T5时VAS评分均明显低于吗啡组(P0.05),复合组患者术后T3~T5时吗啡用量均明显低于吗啡组(P0.05);复合组患者术后瘙痒、恶心和呕吐发生率均明显低于吗啡组(P0.05);与T0时比较,两组患者T1~T5时CD3+、CD4+、CD4+/CD8+和NK细胞水平均降低。复合组患者T2~T5时CD3+水平和CD4+/CD8+均明显高于吗啡组,复合组患者T3~T5时CD4+和NK细胞水平均明显高于吗啡组(P0.05)。结论右美托咪定复合吗啡PCIA用于开胸手术术后镇痛可有效减少吗啡用量,降低镇痛时不良反应发生,改善患者细胞免疫功能。
[Abstract]:Objective to investigate the effect of dexmetomidine combined with morphine PCIA on immune cells after thoracotomy. Methods from March 2012 to April 2014, 112 patients (53 males and 59 females, aged 41 to 60 years) undergoing thoracotomy in our hospital were randomly divided into compound group (n = 51) and morphine group (n = 25), including compound group (n = 51), male group (n = 26) and female group (n = 25). In morphine group, 61 cases (27 males and 34 females) recovered after operation and tracheal catheter was removed. Patients who complained of pain (VAS score 4) were given PCIA.PCIA regimen: patients in the compound group were given 150 ml of drug containing 1.0 渭 g/kg dexmetidine and 0.48mg/kg morphine, while patients in the morphine group were given 150 ml, load of 150 ml, containing 0.48mg/kg morphine, 2 ml, background infusion rate 2 ml/h,. The locking time was 15 min and the VAS score of postoperative pain was 鈮，

本文编号：2292820