摘要
目的探讨七氟醚与丙泊酚全身麻醉对口腔鳞状细胞癌(OSCC)手术患者外周血T淋巴细胞亚群水平的影响。方法前瞻性选取2020年6月至2021年6月在吉林大学口腔医院接受手术治疗的OSCC患者60例为研究对象,采用随机数字表法将患者分为七氟醚组(n=30)与丙泊酚组(n=30)。术中七氟醚组予以2%~4%七氟醚吸入,丙泊酚组予以丙泊酚3~6 mg·kg^(-1)·h^(-1)持续静脉泵注,两组均予以予以瑞芬太尼0.2~0.3μg·kg^(-1)·min^(-1)持续泵注,术中维持脑电双频指数值为40~60。记录两组手术时间、瑞芬太尼用量、舒芬太尼用量和术后24、48、72 h的视觉模拟评分法(VAS)评分;分别于麻醉诱导前30 min和术后24、72 h检测患者外周静脉血T淋巴细胞亚群水平;记录不良反应情况。结果两组手术时间、瑞芬太尼用量、舒芬太尼用量和术后24、48、72 h的VAS评分比较,差异均无统计学意义(P>0.05)。相比麻醉诱导前30 min,两组术后24 h患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)比值均出现显著性降低,差异均有统计学意义(P<0.05);而七氟醚组术后24 h的CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)比值分别为(66.54±6.89)%、(34.21±5.36)%、1.12±0.35,均显著高于丙泊酚组[(55.12±6.36)%、(26.79±5.76)%、0.85±0.27],差异均有统计学意义(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论相比丙泊酚,七氟醚全身麻醉对OSCC患者围手术期细胞免疫功能的抑制作用较轻。
Objective To investigate the effect of sevoflurane and propofol general anesthesia on peripheral blood T lymphocyte subsets in patients with oral squamous cell carcinoma(OSCC).Methods Sixty patients with OSCC who underwent surgical treatment in Stomatological Hospital of Jilin University from June 2020 to June 2021 were prospectively selected as the subjects.The patients were randomly divided into sevoflurane group(n=30)and propofol group(n=30)by random number table method.The sevoflurane group was given 2%~4%sevoflurane inhalation during operation,the propofol group was given propofol 3~6 mg·kg^(-1)·h^(-1) continuous intravenous infusion,and the two groups were given remifentanil 0.2~0.3μg·kg^(-1)·min^(-1) continuous infusion.The bispectral index was maintained at 40~60 during operation.The operation time,remifentanil dosage,sufentanil dosage and VAS scores at 24,48 and 72 h after operation were recorded in the two groups.T lymphocyte subsets in peripheral venous blood of patients were detected 30 min before anesthesia induction and 24 and 72 h after operation,respectively.Adverse reactions were recorded.Results There was no significant difference in the operation time,remifentanil dosage,sufentanil dosage and VAS scores at 24,48 and 72 h after operation between the two groups(P>0.05).Compared with 30 min before anesthesia induction,CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) ratio in the two groups decreased significantly at 24 h after operation,the differences were statistically significant(P<0.05).The CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) ratios at 24 h after operation in the sevoflurane group were(66.54±6.89)%,(34.21±5.36)%,1.12±0.35,significantly higher than those in the propofol group[(55.12±6.36)%,(26.79±5.76)%,0.85±0.27],the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with propofol,sevoflurane general anesthesia has less inhibitory effect on cellular immune fu
作者
尹征
王路平
郑叶
暴晓梅
YIN Zheng;WANG Lu-ping;ZHENG Ye(Department of Anesthesiology,Stomatological Hospital of Jilin University,Changchun Jilin,130000,China.)
出处
《临床和实验医学杂志》
2022年第12期1336-1339,共4页
Journal of Clinical and Experimental Medicine
基金
吉林省教育厅“十三五”科学技术项目(编号:JJKH20201112K)。
关键词
口腔鳞状细胞癌
全身麻醉
七氟醚
丙泊酚
免疫功能
Oral squamous cell carcinoma
General anesthesia
Sevoflurane
Propofol
Immune function
