中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2008年
4期
538-539
,共2页
胡钦擎%李宏青%张晓佳%邓敏茹%纪钦泉%吴丽娟
鬍欽擎%李宏青%張曉佳%鄧敏茹%紀欽泉%吳麗娟
호흠경%리굉청%장효가%산민여%기흠천%오려연
食管肿瘤%T淋巴细胞亚群%麻醉,全身%麻醉,硬膜外
食管腫瘤%T淋巴細胞亞群%痳醉,全身%痳醉,硬膜外
식관종류%T림파세포아군%마취,전신%마취,경막외
Esophageal neoplasms%T-lymphocyte subsets%Anesthesia,general%Anesthesia,epidural
目的 探讨不同麻醉方法对食管癌患者围术期T淋巴细胞亚群的影响.方法 40例择期食管癌根治术患者,随机分为两组,Ⅰ组为全身麻醉组,Ⅱ组为硬膜外阻滞复合全身麻醉组,每组20例.两组分别于麻醉前(T1)、麻醉后(T2)、术毕(T3)、术后1 d(T4)、术后3 d(T5)测外围血T淋巴细胞亚群的变化.结果 两组患者麻醉后CD3、CD4、CD8、CD4/CD8均下降.术后3 d,Ⅰ组CD3(54.85±6.20)%、CD4(35.50±5.65)%、CD8(22.15±1.13)%、CD4/CD8(1.45±0.25);Ⅱ组CD3(61.86 4-4.25)%、CD4(40.85±4.65)%、CD8(20.05±1.14)%、CD4/CD8(1.60±0.15).Ⅱ组指标恢复,与Ⅰ组比较差异有统计学意义.结论 硬膜外阻滞复合全身麻醉能减轻围术期的应激及麻醉药物对T淋巴细胞亚群的抑制,有利于胸科肿瘤患者的免疫功能的及早恢复.
目的 探討不同痳醉方法對食管癌患者圍術期T淋巴細胞亞群的影響.方法 40例擇期食管癌根治術患者,隨機分為兩組,Ⅰ組為全身痳醉組,Ⅱ組為硬膜外阻滯複閤全身痳醉組,每組20例.兩組分彆于痳醉前(T1)、痳醉後(T2)、術畢(T3)、術後1 d(T4)、術後3 d(T5)測外圍血T淋巴細胞亞群的變化.結果 兩組患者痳醉後CD3、CD4、CD8、CD4/CD8均下降.術後3 d,Ⅰ組CD3(54.85±6.20)%、CD4(35.50±5.65)%、CD8(22.15±1.13)%、CD4/CD8(1.45±0.25);Ⅱ組CD3(61.86 4-4.25)%、CD4(40.85±4.65)%、CD8(20.05±1.14)%、CD4/CD8(1.60±0.15).Ⅱ組指標恢複,與Ⅰ組比較差異有統計學意義.結論 硬膜外阻滯複閤全身痳醉能減輕圍術期的應激及痳醉藥物對T淋巴細胞亞群的抑製,有利于胸科腫瘤患者的免疫功能的及早恢複.
목적 탐토불동마취방법대식관암환자위술기T림파세포아군적영향.방법 40례택기식관암근치술환자,수궤분위량조,Ⅰ조위전신마취조,Ⅱ조위경막외조체복합전신마취조,매조20례.량조분별우마취전(T1)、마취후(T2)、술필(T3)、술후1 d(T4)、술후3 d(T5)측외위혈T림파세포아군적변화.결과 량조환자마취후CD3、CD4、CD8、CD4/CD8균하강.술후3 d,Ⅰ조CD3(54.85±6.20)%、CD4(35.50±5.65)%、CD8(22.15±1.13)%、CD4/CD8(1.45±0.25);Ⅱ조CD3(61.86 4-4.25)%、CD4(40.85±4.65)%、CD8(20.05±1.14)%、CD4/CD8(1.60±0.15).Ⅱ조지표회복,여Ⅰ조비교차이유통계학의의.결론 경막외조체복합전신마취능감경위술기적응격급마취약물대T림파세포아군적억제,유리우흉과종류환자적면역공능적급조회복.
Objective To determine the effects of different anesthetic techniques on T-lymphocyte subsets in patients with esophageal carcinoma. Methods Forty patients were randomly assigned into general anesthesia group (group Ⅰ),or combined generae anesthesia with epidural anesthesia group(group Ⅱ). Peripheral blood CD3, CD4,CD8 were measured before induction ( T1 ), after anesthesia ( T2 ), end of operation ( T3 ), 1d ( T4 ), 3d ( T5 ) after surgery. Resolts CD3,CD4,CD8,CD4/CD8 decreased at T2 in the two groups. In group Ⅱ ,CD3,CD4,CD8,CD4/CD8 ratio almost returned to the baseline values at T4 ,while group Ⅰ did not. Conclusion Epidural anesthesia combined with general anesthesia can reduce depression of T-lymphocyte subsets induced by surgical trauma and anesthesia, and is the anesthetic tecnique of choice for cancer patients undergoing major operation.
