CAJ | 학술논문

目的比较两种不同的麻醉及镇痛方法对肺癌根治术患者细胞免疫功能的影响。方法将40例择期剖胸肺癌手术患者分为两组，分别行全凭静脉麻醉联合静脉镇痛（A组）与全麻复合硬膜外麻醉联合硬膜外镇痛（B组），比较两组患者围术期不同时点的T细胞亚群及NK细胞功能的变化。结果两组除CD8+各指标术后均有所上升（P＜0.01）外，其他细胞学指标（CD3+， CD4+，NK细胞）术后均有所下降（P＜0.05或0.01）；B组各指标在术后72h基本恢复术前水平（均P＞0.05），但A组仍与术前有明显差异（P＜0.05或0.01）。结论全麻复合硬膜外麻醉联合术后硬膜外镇痛是肺癌患者免疫功能干扰较小且恢复较快的一种麻醉方式。
목적비교량충불동적마취급진통방법대폐암근치술환자세포면역공능적영향。방법장40례택기부흉폐암수술환자분위량조，분별행전빙정맥마취연합정맥진통（A조）여전마복합경막외마취연합경막외진통（B조），비교량조환자위술기불동시점적T세포아군급NK세포공능적변화。결과량조제CD8+각지표술후균유소상승（P＜0.01）외，기타세포학지표（CD3+， CD4+，NK세포）술후균유소하강（P＜0.05혹0.01）；B조각지표재술후72h기본회복술전수평（균P＞0.05），단A조잉여술전유명현차이（P＜0.05혹0.01）。결론전마복합경막외마취연합술후경막외진통시폐암환자면역공능간우교소차회복교쾌적일충마취방식。
Objective To investigate the effect of two different methods of anesthesia and analgesia on cellular immune function in patients underwent radical resection of pulmonary carcinoma. Methods Forty patients underwent elective thoraco-tomy lung cancer surgery were randomly divided into two groups. Patients were implemented either total intravenous anesthesia combined with intravenous analgesia (group A)or general anesthesia combined with epidural anesthesia and post- op- epidural analgesia (group B). T cellsubsets and NK cellfunction were compared within 72h after surgery. Results Except for the in-crease of CD8+ (P<0.01), postoperative CD3+,CD4+and NK cellwere decreased (P<0.05 or 0.01) in both groups.The indices recovered to the pre- op level in group B 72h after surgery(P>0.05),but not in group A. Conclusion General anesthesia com-bined with epidural anesthesia and post- op epidural analgesia might be an effective anesthesia method with faster recovery and minor interference on the immune function of lung cancer patients.