CAJ | 학술논문

背景手术会增加肿瘤的转移,影响肿瘤患者的长期预后. 目的通过探讨手术影响肿瘤转移的机制来指导麻醉方法和药物的选择,从而减少肿瘤术后转移的机会. 内容介绍了肿瘤转移的过程,以自然杀伤细胞(natural killer cell,NK)和T辅助(T helper,Th)细胞为例阐述了肿瘤与免疫的关系,分析了手术增加肿瘤转移的原因,着重讨论了围术期免疫功能抑制的影响因素,包括神经内分泌,炎症,垂体-下丘脑-肾上腺轴,低体温和输血等5个主要方面.麻醉可以通过β受体阻滞药,环氧酶(cyclo-oxyge-nase,COX)抑制剂,良好的镇痛,区域麻醉,谨慎选择吸入和静脉麻醉药以及保温和节约用血来减少手术对肿瘤转移的影响. 趋向麻醉方法与药物的选择能减少肿瘤术后的转移复发,但仍需大量的前瞻性研究证实.
배경 수술회증가종류적전이,영향종류환자적장기예후. 목적 통과탐토수술영향종류전이적궤제래지도마취방법화약물적선택,종이감소종류술후전이적궤회. 내용 개소료종류전이적과정,이자연살상세포(natural killer cell,NK)화T보조(T helper,Th)세포위례천술료종류여면역적관계,분석료수술증가종류전이적원인,착중토론료위술기면역공능억제적영향인소,포괄신경내분비,염증,수체-하구뇌-신상선축,저체온화수혈등5개주요방면.마취가이통과β수체조체약,배양매(cyclo-oxyge-nase,COX)억제제,량호적진통,구역마취,근신선택흡입화정맥마취약이급보온화절약용혈래감소수술대종류전이적영향. 추향 마취방법여약물적선택능감소종류술후적전이복발,단잉수대량적전첨성연구증실.
Background Surgery increases cancer recurrence,which has a negative effect on long-term prognosis.Objective The paper discussed the mechanism of surgery on cancer recurrence to guide the choice of anesthesia method and drugs in order to decrease postoperative cancer recurrence.Content Introduce the process of cancer recurrence,take natural killer cell (NK) and T helper(Th) cells for example to recite the relationship of cancer and immunity.Analyze the reason that surgery increases cancer recurrence,especially the effects on perioperative immune inhibition,including neuroendocrine,inflammation,HPA axis,hypothermia and blood transfusion.β-receptor blocker,cyclo-oxyge-nase (COX) inhibitor,good analgesia,regional anesthesia,careful selection of inhalation as well as intravenous anesthetics,avoidable hypothermia and unnecessary blood transfusion can reduce the surgery effect on cancer recurrence.Trend Good choice of anesthesia method and drugs may decrease postoperative recurrence of cancer.But plenty of prospective studies are required.