国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
2期
210-213
,共4页
唐春林%尧永华%谭平%苏风华
唐春林%堯永華%譚平%囌風華
당춘림%요영화%담평%소풍화
地佐辛%芬太尼%胃肠道肿瘤%镇痛%免疫功能
地佐辛%芬太尼%胃腸道腫瘤%鎮痛%免疫功能
지좌신%분태니%위장도종류%진통%면역공능
Dezocine%Fentanyl%Gastrointestinal cancer%Analgesia%Immune Function
目的 研究地佐辛与芬太尼术后静脉自控镇痛(PCIA)对胃肠道肿瘤患者免疫功能的影响.方法 将80例肿瘤手术患者按数字表法分为地佐辛组与芬太尼组,每组各40例患者.芬太尼组采用芬太尼0.8 mg+生理盐水稀释到100 ml镇痛方案;地佐辛组采用镇痛泵使用前先静脉注射5 mg负荷量的地佐辛,然后采用地佐辛20 mg+生理盐水稀释到100 ml的镇痛方案.手术前、手术后24小时、48小时、72小时测定患者外周血T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+).结果 两组患者的一般资料无统计学差异.两组术后24小时CD3+、CD4+、CD4+/CD8+均较手术前降低,差异有显著性(P＜0.05),两组术后24小时CD3+、CD4+相比地佐辛组更高,差异有显著性(P＜0.05),48小时后两组均升高,而芬太尼组仍低于手术前水平,地佐辛组则恢复接近正常水平,两组相比地佐辛组高于芬太尼组,差异有显著性(P＜0.05),72小时后两组均恢复至术前水平.结论 地佐辛术后静脉自控镇痛对患者免疫功能抑制较轻,术后患者免疫功能恢复较快,对机体的免疫功能有较好的保护作用,值得老年胃肠道肿瘤患者临床广泛推广应用.
目的 研究地佐辛與芬太尼術後靜脈自控鎮痛(PCIA)對胃腸道腫瘤患者免疫功能的影響.方法 將80例腫瘤手術患者按數字錶法分為地佐辛組與芬太尼組,每組各40例患者.芬太尼組採用芬太尼0.8 mg+生理鹽水稀釋到100 ml鎮痛方案;地佐辛組採用鎮痛泵使用前先靜脈註射5 mg負荷量的地佐辛,然後採用地佐辛20 mg+生理鹽水稀釋到100 ml的鎮痛方案.手術前、手術後24小時、48小時、72小時測定患者外週血T淋巴細胞亞群(CD3+、CD4+、CD4+/CD8+).結果 兩組患者的一般資料無統計學差異.兩組術後24小時CD3+、CD4+、CD4+/CD8+均較手術前降低,差異有顯著性(P＜0.05),兩組術後24小時CD3+、CD4+相比地佐辛組更高,差異有顯著性(P＜0.05),48小時後兩組均升高,而芬太尼組仍低于手術前水平,地佐辛組則恢複接近正常水平,兩組相比地佐辛組高于芬太尼組,差異有顯著性(P＜0.05),72小時後兩組均恢複至術前水平.結論 地佐辛術後靜脈自控鎮痛對患者免疫功能抑製較輕,術後患者免疫功能恢複較快,對機體的免疫功能有較好的保護作用,值得老年胃腸道腫瘤患者臨床廣汎推廣應用.
목적 연구지좌신여분태니술후정맥자공진통(PCIA)대위장도종류환자면역공능적영향.방법 장80례종류수술환자안수자표법분위지좌신조여분태니조,매조각40례환자.분태니조채용분태니0.8 mg+생리염수희석도100 ml진통방안;지좌신조채용진통빙사용전선정맥주사5 mg부하량적지좌신,연후채용지좌신20 mg+생리염수희석도100 ml적진통방안.수술전、수술후24소시、48소시、72소시측정환자외주혈T림파세포아군(CD3+、CD4+、CD4+/CD8+).결과 량조환자적일반자료무통계학차이.량조술후24소시CD3+、CD4+、CD4+/CD8+균교수술전강저,차이유현저성(P＜0.05),량조술후24소시CD3+、CD4+상비지좌신조경고,차이유현저성(P＜0.05),48소시후량조균승고,이분태니조잉저우수술전수평,지좌신조칙회복접근정상수평,량조상비지좌신조고우분태니조,차이유현저성(P＜0.05),72소시후량조균회복지술전수평.결론 지좌신술후정맥자공진통대환자면역공능억제교경,술후환자면역공능회복교쾌,대궤체적면역공능유교호적보호작용,치득노년위장도종류환자림상엄범추엄응용.
Objective To investigate the effect of patient controlled intravenous analgesia (PCIA) with dezocine and fentanyl on the distribution of T-Iymphocytes in elderly patients with gastrointestinal cancer.Method8 80 patients with tumor undergoing radical operation were randomly divided into dezocine group and fentanyl group,40 cases in each group.All patients used PCIA.The analgesic regimen of fentanyl group was 0.8 mg fentanyl+saline diluted to 100 ml,the analgesic regimen of dezocine group was dezocine 20 mg+saline diluted to 100 ml after intravenous injection of 5 mg load of dezocine.Peripheral blood samples were obtained before operation,24,48,72 hours after operation.T-Iymphocyte subsets were measured,and used VAS score to record patients' satisfaction.Results The amount of CD3+,CD4+,CD4+/CD8+ lymphocytes decreased 24 hours after operation in two groups (P＜0.05),The amount of CD3+,CD4+,CD4+/CD8+ lymphocytes in dezocine groups were nearly to baseline in 48 hours postoperatively,and sign ficandy higher than those of fentanyl group.The whole T-Iymphocytes recovered in 72 hours postoperatively in two groups.Conclusion Dezocine has less impact on immune function in elderly patients with gastrointestinal cancer.
