磷酸肌酸钠预处理对老年胃癌手术患者循环功能及术后早期疲劳状态、免疫功能的影响
发布时间：2018-10-30 07:38
【摘要】：目的探讨磷酸肌酸钠预处理对老年胃癌手术患者循环功能及术后早期疲劳状态、机体免疫功能的影响。方法将80例行胃癌根治术老年患者随机分为观察组和对照组各40例,均给予相同的麻醉诱导、麻醉维持及手术方法。观察组在麻醉诱导前给予磷酸肌酸钠2 g加入0.9%氯化钠注射液100 m L中静滴,术后第1~3天继续滴注;对照组给予等容积0.9%氯化钠注射液静滴。对比分析两组麻醉诱导前(T0)、气管插管即刻(T_1)、气管插管后5 min(T_2)、开腹即刻(T_3)、开腹后5 min(T_4)患者心排血量(CO)、每搏输出量(SV)以及左心室舒张末期容积(LVEDV),术后第1、2、3天疲劳指数,术前及术后第1、3天T淋巴细胞亚群及免疫球蛋白。结果两组T_1、T_2、T_3、T_4时CO、SV均较T0时降低,LVEDV升高,且T_2、T_4时变化最明显(P均0.05或0.01);而对照组T_2、T_4时CO、SV低于观察组,T_4时LVEDV高于观察组(P均0.01)。两组术后第1、2、3天疲劳指数评分均高于术前(P均0.01),并呈现先升高后降低趋势,术后第2、3天观察组疲劳指数评分低于对照组(P0.05或0.01)。术后第1天两组CD3~+、CD4~+T淋巴细胞水平及CD4~+/CD8~+均较术前降低,且对照组CD4~+T淋巴细胞水平及CD4~+/CD8~+低于观察组(P均0.01);术后第3天两组CD3~+、CD4~+T淋巴细胞水平及CD4~+/CD8~+均较术后第1天升高,且观察组CD4~+T淋巴细胞水平及CD4~+/CD8~+高于对照组,CD8~+T淋巴细胞水平低于对照组(P均0.05或0.01)。术后第1、3天两组血清Ig A、Ig G、Ig M水平均较术前降低(P均0.01),且观察组各指标略高于对照组(P均0.05),但术后第3天观察组Ig A水平高于对照组(P0.05)。结论磷酸肌酸钠预处理能改善老年胃癌患者术中循环功能,同时能在一定程度上减轻患者术后早期疲劳程度及免疫抑制状态,从而促进其早期恢复。
[Abstract]:Objective to investigate the effects of creatine phosphate preconditioning on circulatory function, early postoperative fatigue and immune function in elderly patients with gastric cancer. Methods 80 elderly patients undergoing radical gastrectomy were randomly divided into the observation group (n = 40) and the control group (n = 40). All patients were given the same anesthesia induction, anesthesia maintenance and operation methods. Before anesthesia induction, the observation group received intravenous drip of creatine phosphate sodium phosphate (2g) and 0.9% sodium chloride injection (100ml), and the control group received 0.9% sodium chloride injection (0.9% sodium chloride) intravenously on the 1st day after operation. (CO), of cardiac output was compared between two groups before anesthesia induction (T0), immediately after tracheal intubation (TCI), 5 min after endotracheal intubation (T _ 2), immediately after operation (T _ 3), 5 min after operation (T _ 4). The fatigue index of left ventricular end-diastolic volume (LVEDV),) and left ventricular end-diastolic volume (LVEDV),) was 3 days after operation, and the T lymphocyte subsets and immunoglobulins before and 1 day after operation. Results in both groups, CO,SV decreased and LVEDV increased at T _ 1 / T _ 2T _ 3 / T _ S _ 4 and T _ (2) / T _ (4) (all P < 0. 05 or 0. 01). However, the CO,SV of the control group at T _ 2 and T _ 4 was lower than that of the observation group, and the LVEDV at T _ (4) was higher than that in the observation group (P < 0.01). The scores of fatigue index on the 1st and 2nd day after operation in both groups were higher than those before operation (P 0.01), and the fatigue index scores in the observation group were lower than those in the control group on the 2nd day after operation (P0.05 or 0.01). On the first day after operation, the levels of CD3~, CD4~ T lymphocytes and CD4~ / CD8~ in the two groups were lower than those before operation, and the levels of CD4~ T lymphocytes and CD4~ / CD8~ in the control group were lower than those in the observation group (P0.01). On the 3rd day after operation, the levels of CD3~, CD4~ T lymphocytes and CD4~ / CD8~ in the two groups were higher than those in the control group, and the levels of CD4~ T lymphocytes and CD4~ / CD8~ in the observation group were higher than those in the control group. The level of CD8~ T lymphocyte was lower than that of control group (P 0. 05 or 0. 01). On the 1st day after operation, the serum levels of Ig G M in the two groups were lower than those before operation (P 0.01), and the indexes in the observation group were slightly higher than those in the control group (P 0.05). But on the third day after operation, the Ig A level in the observation group was higher than that in the control group (P 0.05). Conclusion the pretreatment with creatine phosphate can improve the circulatory function of the aged patients with gastric cancer during operation, at the same time, it can alleviate the early fatigue and immunosuppressive state of the patients, and promote the early recovery of gastric cancer.
【作者单位】： 南京医科大学附属无锡市第二人民医院;南京医科大学附属无锡市人民医院;
【分类号】：R735.2
本文编号：2299367
[Abstract]:Objective to investigate the effects of creatine phosphate preconditioning on circulatory function, early postoperative fatigue and immune function in elderly patients with gastric cancer. Methods 80 elderly patients undergoing radical gastrectomy were randomly divided into the observation group (n = 40) and the control group (n = 40). All patients were given the same anesthesia induction, anesthesia maintenance and operation methods. Before anesthesia induction, the observation group received intravenous drip of creatine phosphate sodium phosphate (2g) and 0.9% sodium chloride injection (100ml), and the control group received 0.9% sodium chloride injection (0.9% sodium chloride) intravenously on the 1st day after operation. (CO), of cardiac output was compared between two groups before anesthesia induction (T0), immediately after tracheal intubation (TCI), 5 min after endotracheal intubation (T _ 2), immediately after operation (T _ 3), 5 min after operation (T _ 4). The fatigue index of left ventricular end-diastolic volume (LVEDV),) and left ventricular end-diastolic volume (LVEDV),) was 3 days after operation, and the T lymphocyte subsets and immunoglobulins before and 1 day after operation. Results in both groups, CO,SV decreased and LVEDV increased at T _ 1 / T _ 2T _ 3 / T _ S _ 4 and T _ (2) / T _ (4) (all P < 0. 05 or 0. 01). However, the CO,SV of the control group at T _ 2 and T _ 4 was lower than that of the observation group, and the LVEDV at T _ (4) was higher than that in the observation group (P < 0.01). The scores of fatigue index on the 1st and 2nd day after operation in both groups were higher than those before operation (P 0.01), and the fatigue index scores in the observation group were lower than those in the control group on the 2nd day after operation (P0.05 or 0.01). On the first day after operation, the levels of CD3~, CD4~ T lymphocytes and CD4~ / CD8~ in the two groups were lower than those before operation, and the levels of CD4~ T lymphocytes and CD4~ / CD8~ in the control group were lower than those in the observation group (P0.01). On the 3rd day after operation, the levels of CD3~, CD4~ T lymphocytes and CD4~ / CD8~ in the two groups were higher than those in the control group, and the levels of CD4~ T lymphocytes and CD4~ / CD8~ in the observation group were higher than those in the control group. The level of CD8~ T lymphocyte was lower than that of control group (P 0. 05 or 0. 01). On the 1st day after operation, the serum levels of Ig G M in the two groups were lower than those before operation (P 0.01), and the indexes in the observation group were slightly higher than those in the control group (P 0.05). But on the third day after operation, the Ig A level in the observation group was higher than that in the control group (P 0.05). Conclusion the pretreatment with creatine phosphate can improve the circulatory function of the aged patients with gastric cancer during operation, at the same time, it can alleviate the early fatigue and immunosuppressive state of the patients, and promote the early recovery of gastric cancer.
【作者单位】： 南京医科大学附属无锡市第二人民医院;南京医科大学附属无锡市人民医院;
【分类号】：R735.2
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