文章摘要
张林忠1*,朱镭2.氟比洛芬酯联合舒芬太尼术后静脉镇痛对食管癌患者淋巴细胞亚群的影响[J].山西医科大学学报,2009,40(4):356~359
氟比洛芬酯联合舒芬太尼术后静脉镇痛对食管癌患者淋巴细胞亚群的影响
Effect of flurbiprofen axetil combined with sufentanyl on lymphocyte subsets in patients with esophageal cancer after radical operation
  
DOI:
中文关键词: 术后镇痛  〓食管肿瘤  〓淋巴细胞  〓免疫
英文关键词: postoperative analgesia  〓esophageal neoplasma  〓lymphocyte  〓immunity
基金项目:山西医科大学青年基金资助项目(057207)
作者单位
张林忠1*,朱镭2 1山西医科大学第二临床医学院麻醉科太原030001
2山西医科大学第二临床医学院血液实验室
*通讯作者,Tel:0351-3365790,E mail:zlz0068@yahoo.com.cn 
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中文摘要:
      目的〓 观察联合应用氟比洛芬酯和舒芬太尼术后静脉镇痛对食管癌患者外周血淋巴细胞亚群的影响。 〓方法〓 选择行中下段食管癌根治术患者26例,随机分为氟比洛芬酯联合舒芬太尼镇痛组(F组,n=13)和舒芬太尼镇痛组(S组,n=13)。两组患者都接受相同的气管插管、靶控输注全凭静脉麻醉。术毕分别用氟比洛芬酯联合舒芬太尼和单纯舒芬太尼行静脉术后镇痛,采用VAS镇痛评分评价镇痛效果,并分别于麻醉前、术毕、术后4 h、术后24 h和术后48 h抽取静脉血,用流式细胞仪检测T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8〖+比值及NK细胞(CD16+、CD56+/CD3-)的变化。 〓结果〓 两组患者术后镇痛VAS评分无统计学差异;两组患者CD3+、CD4+淋巴细胞在术毕、术后4 h均较术前明显降低(P<0.05),术后24 h,48 h有所恢复;CD8+细胞各时点变化差异无统计学意义。CD4+/CD8+、NK细胞在S组患者术后各时点均低于术前(P<0.05),而F组患者在术毕及术后4 h明显低于术前(P<0.05),术后48 h与术前比较差异无统计学意义。 〓结论〓 氟比洛芬酯联合舒芬太尼和单纯舒芬太尼术后镇痛都取得良好的镇痛效果,但前者更有利于食管癌患者术后细胞免疫功能的恢复。
英文摘要:
      Objective〓 To evaluate the effect of postoperative analgesia with flurbiprofen axetil combined with sufentanyl on T lymphocyte subsets in patients with middle lower section esophageal cancer after radical operation. 〓Methods〓 Twenty six patients undergoing radical operation of middle lower section esophageal cancer were randomly assigned into two groups:F group and S group.All patients were given identical total intravenous anesthesia with target controlled infusion of propofol and remifentanil.Then patients received postoperative analgesia with flurbiprofen axetil combined with sufentanyl after operation in F group,but only sufentanyl in S group.Periphe ral blood samples were obtained before anesthesia,after operation for 0 h,4 h,24 h,and 48 h,respectively.The T lymphocyte subsets and natural killer cells(NK)were measured by flow cytometry. 〓Results〓 There was no significant difference in visual analogue scale(VAS)between F group and S group.In both groups, the amounts of CD3〖KG-*4〗+,CD4〖KG-*4〗+ lymphocyte significantly decreased after operation for 0 h and 4 h than that before operation(P<0.05),and restored after operation for 24 h and 48 h.The CD8〖KG-*3〗+ lymphocyte showed no significant change during the whole experiment.In S group,the ratio of CD4+/CD8+ and NK cells were significantly lower after operation than that before operation(P<0.05),while in F group,the two indices also decreased after operation for 0 h and 4 h compared with that before operation(P<0.05),but after operation for 48 h,they recovered nearly to the level before operation. 〓Conclusion〓 Postoperative analgesia with flurbiprofen axetil and sufentanyl or with sufentanyl alone shows a similar postoperative analgesic effect in patients undergoing radical operation of middle lower section esophageal cancer, but the former protocol more contributes to recover cell mediated immunity of the patients suffering excision of esophageal cancer.
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