| 引用本文： |
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胡超力,王芬,周英杰,等.不同镇痛方式对腹腔镜结直肠癌根治术后早期细胞免疫功能的影响[J].同济大学学报（医学版）,2016,37(5):54-57. [点击复制]
- HU Chao-li,WANG Fen,ZHOU Ying-jie,et al.Effects of different analgesia regimens on early cellular immunity in patients undergoing laparoscopic resection of colorectal cancer[J].同济大学学报（医学版）,2016,37(5):54-57. [点击复制]
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| 摘要: |
| 目的 比较不同镇痛方式对腹腔镜结直肠癌根治术后早期细胞免疫功能的影响。方法 择期行腹腔镜结直肠癌根治术患者124例,采用随机数字表法随机分为: 硬膜外镇痛组(EA组,n=42)、腹横肌平面阻滞组(TAPB组,n=41)和静脉镇痛组(PCIA组,n=41)。3组患者全身麻醉诱导维持用药相同,EA组行硬膜外阻滞和硬膜外镇痛,TAPB组行双侧TAP阻滞,PCIA组予PCIA镇痛。术前(T0)、全身麻醉诱导后2h(T1)、术后1d(T2)、术后3d(T3)、术后7d或者患者出院前(T4)分别抽取静脉血2ml,采用流式细胞技术检测患者细胞免疫功能。结果 3组患者T2 CD4+均比T0显著降低；TAPB组和PCIA组T2 CD4+/CD8+均比T0显著降低；EA组T2总T淋巴细胞比T0显著降低(均P＜0.05)。与EA组比较,PCIA组T1自然杀伤细胞(NK细胞)显著降低。结论 无论何种镇痛技术,腹腔镜结直肠癌根治术患者术后第1天的T辅助细胞受到明显抑制,全身麻醉联合硬膜外镇痛对患者术中NK细胞数量的减少有益。 |
| 关键词: 镇痛 结直肠癌根治术 细胞免疫 |
| DOI：10.16118/j.1008-0392.2016.05.011 |
| 投稿时间：2016-02-21 |
| 基金项目: |
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| Effects of different analgesia regimens on early cellular immunity in patients undergoing laparoscopic resection of colorectal cancer |
| HU Chao-li,WANG Fen,ZHOU Ying-jie,WANG Hui-ying,FU Shu-kun |
| (Dept. of Anesthesiology, Tenth People's Hospital, Tongji University, Shanghai 200072, China) |
| Abstract: |
| Objective To compare effects of different analgesia regimens on early cellular immunity in patients undergoing laparoscopic resection of colorectal cancer. Methods One hundred and twenty two patients scheduled to undergo laparoscopic resection of colorectal cancer were randomly divided into three groups. Same anesthesia induction and maintenance medication were used in three groups； 40 patients in EA group received epidural block and epidural analgesia, 41 patients in TAP group received bilateral transverse abdominis plane block and 41 patients in PCIA group received patient-controlled intravenous analgesia. Blood samples were collected in 1d before operation(T0), 2h after induction(T1), 1d(T2), 3d(T3) and 7d(T4) after operation, respectively. Flow cytometry was used to detect cellular immune function. Results The helper T-lymphocyte count(CD4+) at T2 was lower than that at T0 in all three groups(P＜0.05)； the ratio of CD4+/CD8+ of TAPB group and PCIA group at T2 was lower than that at T0. The total T- lymphocyte count at T2 was less than that at T0 in EA group. Compared to EA group, the NK cell in PCIA group was lower. Conclusion The helper T-lymphocyte account after the first day of laparoscopic resection of colorectal cancer is significantly reduced in all three analgesic regimes. General anesthesia combined with epidural analgesia is beneficial in maintaining NK cell levels during the operation. |
| Key words: analgesic laparoscopic resection of colorectal cancer cellular immunity |
