右美托咪定联合羟考酮对胃癌根治术患者免疫功能的影响

发布时间：2018-05-18 23:47

本文选题：胃肿瘤 + 免疫　；参考：《中华普通外科学文献(电子版)》2016年06期

【摘要】：目的观察右美托咪定联合羟考酮对胃癌根治术患者免疫功能的影响。方法选择新疆维吾尔自治区人民医院2015年6月至2016年3月全麻下行胃癌根治术患者60例,用随机数字表法将其分为2组:羟考酮组(O组)和右美托咪定联合羟考酮组(DO组),每组30例。所有患者行静脉全麻,静脉泵注异丙酚4~6 mg·kg~(-1)·h~(-1),靶控输注瑞芬太尼3~4μg/L,术毕前30 min静脉注射羟考酮0.04 mg/kg;DO组诱导后以0.5μg·kg~(-1)·min~(-1)的速度静脉泵注右美托咪定至术毕前30 min。术毕采用经静脉自控镇痛。于术前(T0)、术毕(T1)、术后4 h(T2)和8 h(T3)时抽取静脉血标本,用流式细胞仪测定T淋巴细胞亚群CD3+、CD4+、CD8+和NK细胞CD16+/CD56+水平,计算CD4+/CD8+比值。记录术后镇痛VAS评分、恶心呕吐、呼吸抑制、头痛等不良反应发生情况。结果与T0时比较,两组T1、T2时CD3+、CD4+、CD4+/CD8+比值、NK细胞CD16+/CD56+水平降低,CD8+水平升高(P0.01)。与O组比较,DO组T1、T2时CD3+、CD4+、CD4+/CD8+比值和NK细胞CD16+/CD56+水平升高(P0.01),不良反应发生率差异无统计学意义。结论右美托咪定联合羟考酮对胃癌根治术患者术后免疫功能抑制程度较单纯羟考酮减轻。
[Abstract]:Objective to observe the effect of dexmetomidine combined with hydroxycodone on immune function of patients undergoing radical gastrectomy. Methods from June 2015 to March 2016, 60 patients with gastric cancer underwent radical gastrectomy under general anesthesia in Xinjiang Uygur Autonomous region people's Hospital. The patients were randomly divided into two groups: hydroxycodone group (n = 30) and dexmetomidine combined with hydroxycodone group (n = 30). All patients were given intravenous general anesthesia, propofol 6 mg / kg 路min -1), target controlled infusion of remifentanil 3 渭 g / L, intravenous injection of hydroxycodone 0.04 mg / kg DO 30 min before operation, intravenous injection of 0.5 渭 g kg 路kg -1 路min ~ (-1) 路min ~ (-1) of dexmetotidine, 30 mins before the end of operation, and 30 min after operation, intravenous injection of hydroxycodon 0.04 mg 路kg ~ (-1) 路min ~ (-1) 路min ~ (-1). Patient controlled analgesia via vein was used at the end of operation. Venous blood samples were collected at the time of T0, T1, T2) and T3. The levels of T lymphocyte subsets, CD3, CD 4, CD 8 and NK cell CD16 / CD 56 were measured by flow cytometry, and the ratio of CD4 / CD 8 was calculated. Postoperative VAS scores, nausea and vomiting, respiratory depression, headache and other adverse events were recorded. Results compared with T _ 0, the levels of CD16 / CD _ 56 of NK cells in T _ 1 / T _ 2 group and the ratio of CD4 / CD _ 8 to CD _ 4 / CD _ 8 in T _ 1 / T _ 2 group were significantly lower than those at T _ (0). Compared with O group, the ratio of CD3 CD4 / CD8 and NK cell CD16 / CD56 increased at T _ 1 and T _ 2 in do group. There was no significant difference in the incidence of adverse reactions. Conclusion dexmetomidine combined with hydroxycodone can decrease the immune function of patients with gastric cancer after radical operation.
【作者单位】：新疆维吾尔自治区人民医院麻醉科;南充市中心医院麻醉科;
【分类号】：R614;R735.2

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