CAJ | 학술논문

目的评价轻度低温对直肠癌根治术患者细胞免疫功能的影响.方法择期拟行直肠癌根治术患者50例,ASA分级Ⅰ或Ⅱ级,年龄30～64岁,采用随机数字表法,将其随机分为轻度低温组和常温组,每组25例.分别于麻醉前1 h(T1)、手术结束时(T2)、术后24 h(T3)及术后第7天(T4)采用流式细胞仪测定血清Th1型、Th2型细胞因子水平,计算Th1/Th2比值.结果与T1时比较,常温组T4时血清Th2型细胞因子平降低,Th1/Th2比值升高,轻度低温组T2.3时血清Th1型细胞因子水平及Th1/Th2比值降低,血清Th2型细胞因子水平升高(P＜0.05)；与常温组比较,轻度低温组T2-4时血清Th1型细胞因子水平及Th1/Th2比值降低,血清Th2型细胞因子水平升高(P＜0.05).结论轻度低温可降低机体抗肿瘤的细胞免疫功能.
목적 평개경도저온대직장암근치술환자세포면역공능적영향.방법 택기의행직장암근치술환자50례,ASA분급Ⅰ혹Ⅱ급,년령30～64세,채용수궤수자표법,장기수궤분위경도저온조화상온조,매조25례.분별우마취전1 h(T1)、수술결속시(T2)、술후24 h(T3)급술후제7천(T4)채용류식세포의측정혈청Th1형、Th2형세포인자수평,계산Th1/Th2비치.결과 여T1시비교,상온조T4시혈청Th2형세포인자평강저,Th1/Th2비치승고,경도저온조T2.3시혈청Th1형세포인자수평급Th1/Th2비치강저,혈청Th2형세포인자수평승고(P＜0.05)；여상온조비교,경도저온조T2-4시혈청Th1형세포인자수평급Th1/Th2비치강저,혈청Th2형세포인자수평승고(P＜0.05).결론 경도저온가강저궤체항종류적세포면역공능.
Objective To investigate the effects of mild pefioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer.Methods Fifty ASA Ⅰ or Ⅱ patients aged 30-64 yr undergoing surgery for rectal cancer were randomly divided into 2 groups ( n =25 each):mild hypothermia group and normal body temperature group.Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with propofol,remifentanil and vecuronium.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 35-45 mm Hg.The venous blood samples were taken from peripheral vein at 1 h before anesthesia (T1 ),at the end of operation (T2),at 24 h after operation (T3),and on 7th day after operation (T4) to measure the serum Th1 and Th2 cytokines levels and Th1/Th2 cytokines balance was observed.Results Compared with the baseline value at T1,the serum Th2 cytokines level was significantly decreased and Th1/Th2 ratio was significantly increased at T4 in normal body temperature group,and the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2.3 in mild hypothermia group ( P ＜ 0.05).Compared with normal body temperature group,the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2-4 in mild hypothermia group ( P ＜ 0.05).Conclusion Mild perioperative hypothermia can depress cellular immune function in patients undergoing surgery for rectal cancer.