曲马多术后自控镇痛对胃癌患者静脉血Th细胞分化的影响

发布时间：2018-12-12 16:56

【摘要】：目的探讨曲马多术后自控镇痛对胃癌患者静脉血辅助性T淋巴细胞(Th)分化的影响。方法将166例胃癌患者分为观察组(85例)和对照组(81例),两组术后均行患者自控静脉镇痛(PCIA),观察组所用药物为曲马多,对照组使用芬太尼。采用视觉模拟评分法(VAS)和舒适度评分(BCS)评价术后PCIA的效果。采用流式细胞仪检测外周血单个核细胞(PBMCs)中Th1、Th2细胞。结果两组患者术后12、48h的VAS评分均比术后4h时明显下降(P0.05);两组患者术后48h的BCS评分均明显升高(P0.05);两组患者同期VAS、BCS评分比较,差异均无统计学意义(P0.05)。两组患者术后的Th1细胞百分率、Th1/Th2比术毕时均明显下降(P0.05);两组术后的Th2细胞百分率比术毕时明显升高(P0.05);两组患者术后4、48h的Th1、Th2细胞百分率及Th1/Th2比较,差异均有统计学意义(P0.05)。观察组不良反应发生率为7.06%(6/85),对照组为8.64%(7/81),两组比较差异无统计学意义(χ~2=0.144,P0.05)。结论胃癌患者术后采用曲马多PCIA的镇痛效果明显,可促进Th细胞分化平衡,改善患者的免疫抑制状态。
[Abstract]:Objective to investigate the effect of tramadol patient-controlled analgesia on (Th) differentiation of peripheral blood helper T lymphocytes in patients with gastric cancer. Methods 166 patients with gastric cancer were divided into two groups: observation group (n = 85) and control group (n = 81). Tramadol was used for patient-controlled intravenous analgesia (PCIA),) and fentanyl was used in control group. Visual analogue score (VAS) and comfort score (BCS) were used to evaluate the effect of postoperative PCIA. Flow cytometry was used to detect Th1,Th2 cells in peripheral blood mononuclear cells (PBMCs). Results the VAS scores of the two groups were significantly lower than that of the patients at 4 hours after operation (P0.05), and the BCS scores of the two groups increased significantly at 48 hours after operation (P0.05). There was no significant difference in VAS,BCS score between the two groups (P0.05). The percentage of Th1 cells and the percentage of Th2 cells in the two groups were significantly lower than those at the end of operation (P0.05), and the percentage of Th2 cells in the two groups was significantly higher than that at the end of operation (P0.05). The percentage of Th1,Th2 cells and Th1/Th2 were significantly different between the two groups at 48 h after operation (P0.05). The incidence of adverse reactions was 7.06% (6 / 85) in the observation group and 8.64% (7 / 81) in the control group. There was no significant difference between the two groups (蠂 ~ 2 ~ (0.144) P 0.05). Conclusion the analgesic effect of tramadol PCIA on gastric cancer patients after operation is obvious. It can promote the differentiation and balance of Th cells and improve the immunosuppressive state of the patients.
【作者单位】：浙江新安国际医院麻醉科;
【分类号】：R614;R735.2

【相似文献】