摘要
目的探讨舒芬太尼复合氟比洛芬酯PCIA对老年肺癌根治术患者细胞免疫功能的影响。方法择期行肺癌根治术患者40例，年龄65-72岁，随机均分为两组：舒芬太尼复合氟比洛芬酯组（SF组）：舒芬太尼75μg＋氟比洛芬酯200mg；舒芬太尼组（S组）：舒芬太尼150μg。两组均用生理盐水稀释至200ml，镇痛泵参数设置：持续输注量4．0ml／h、PCA剂量0．5ml、锁定时间15min。记录术后6、12、24、48h的疼痛VAS评分、Ramsay镇静评分和嗜睡、恶心呕吐、皮肤瘙痒、呼吸抑制、血压下降、消化道出血等不良反应。分别于术前、术后1、7d测定外周静脉血CD3＋、CD4＋、CD8＋、CD4＋／CD8＋和自然杀伤（NK）细胞水平。结果两组患者术后不同时点VAS、Ramsay评分差异无统计学意义。与术前比较，两组术后1d的CD3＋、CD4＋、CD4＋／CD8＋和NK细胞水平明显降低，术后7d的NK细胞水平明显降低（P〈0．05）。与S组比较，SF组术后1d的CD3＋、CD4＋、CD4＋／CD8＋水平，术后1、7d的NK细胞水平明显升高（P〈0．05）。两组患者不良反应差异无统计学意义。结论舒芬太尼复合氟比洛芬酯PCIA可提高老年肺癌根治术患者术后CD3＋、CD4＋、CD4＋／CD8＋和NK细胞水平，其效果优于单纯使用舒芬太尼。
Objective To investigate the effects of sufentanil combined with flurbiprofen axefil for PCIA on cellular immunity in elderly patients after radical cancer surgery. Methods Forty ASA Ⅰ or Ⅱ patients aged 65-72 years old undergoing radical lung cancer surgery were randomly divided into two groups with 20 cases each. Group SF was given sufentanil 75μg combined flurbiprofen axefil 200 mg plus ondansetron 16 mg. Group S received sufentanil 150 μg plus ondansetron 16 mg. The pump was diluted to 200 ml via PCIA after surgery for 48 h in two groups. The PCIA rate was 4ml/h, blous 0.5 ml,lock time 15 min. The VAS score, Ramsay sedation scores and side effects were recorded. Blood samples were taken before surgery and 1,7 d after surgery for determination of CD3＋, CD4＋, CD8＋and CD4 ＋/CD8 ＋ratio and the level of natural killer （NK） ceils. Results There was no significant differences in VAS, Ramsay scores and side effects between two groups. The levels of CD3 ＋,CD4＋, CD4＋/CD8＋ and NK cells.at 1 d after surgery and NK cells at 7 d after surgery were lower than those before surgery in two group, which were significantly higer in group SF at 1,7 d after surgery than that in group S. Conclusion The effect of sufentanil combined with flurbiprofen axefil for PCIA in increasing the levels of CD3 ＋, CD4 ＋, CD4 ＋/CD8 ＋ and NK cells in elderly patients after radical ,cancer surgery is-better than that of sufentanil.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第10期962-964,共3页
Journal of Clinical Anesthesiology
基金
广西医疗卫生科研课题(桂卫Z2009144)
关键词
细胞免疫
舒芬太尼
氟比洛芬酯
患者静脉自控镇痛
肺癌
老年
Cellular immunity
Sufentanil
Flurbiprofen axefil
Patient controlled intravenous analgesia
Lung neoplasms
Elderly
