CAJ | 학술논문

目的：探讨右美托咪定用于食管癌根治术后清醒镇静对细胞免疫功能的影响。方法食管癌患者140例随机分为治疗组与对照组，每组各70例，两组均选择静吸复合插管全身麻醉，并顺利完成食管癌根治术，对照组术后进行常规硬膜外自控镇痛，在此基础上治疗组加用右美托咪定进行清醒镇静。结果两组术毕及术后72 h外周血CD3＋和CD3＋CD8＋ T细胞绝对值均明显低于术前（ P＜0．05），治疗组术毕及术后72 h外周血CD3＋和CD3＋CD8＋ T细胞绝对值明显高于对照组（P＜0．05）。随着术后的恢复，两组的视觉模拟量表（VAS）评分都呈现明显下降的趋势（P＜0．05），同时治疗组术后24 h与术后72 h的VAS评分明显低于对照组（P＜0．05）。治疗组术后排气时间、进流质时间与住院时间都明显少于对照组（P＜0．05）。疗组术后切口出血、切口感染、肺部感染等并发症发生情况明显低于对照组（P＜0．05）。结论右美托咪定有助于调整食管癌根治术后免疫紊乱，缓解疼痛，安全性好，值得推广应用。
목적：탐토우미탁미정용우식관암근치술후청성진정대세포면역공능적영향。방법식관암환자140례수궤분위치료조여대조조，매조각70례，량조균선택정흡복합삽관전신마취，병순리완성식관암근치술，대조조술후진행상규경막외자공진통，재차기출상치료조가용우미탁미정진행청성진정。결과량조술필급술후72 h외주혈CD3＋화CD3＋CD8＋ T세포절대치균명현저우술전（ P＜0．05），치료조술필급술후72 h외주혈CD3＋화CD3＋CD8＋ T세포절대치명현고우대조조（P＜0．05）。수착술후적회복，량조적시각모의량표（VAS）평분도정현명현하강적추세（P＜0．05），동시치료조술후24 h여술후72 h적VAS평분명현저우대조조（P＜0．05）。치료조술후배기시간、진류질시간여주원시간도명현소우대조조（P＜0．05）。료조술후절구출혈、절구감염、폐부감염등병발증발생정황명현저우대조조（P＜0．05）。결론우미탁미정유조우조정식관암근치술후면역문란，완해동통，안전성호，치득추엄응용。
Objective To investigate the influence of dexmedetomidine used for sedation after esophageal car‐cinoma radical resection on cellular immune function .Methods 140 cases of esophageal carcinoma were randomly di‐vided into the treatment group and the control group with 70 cases in each group .The two groups selected the intra‐venous inhalation combined intubation general anesthesia and the radical resection of esophageal cancer was smoothly completed .The control group was performed the conventional patient‐controlled epidural analgesia after surgery , while on this basis the treatment group was added with dexmedetomidine for sedation .Results The peripheral blood CD3+ and CD3+CD8+ lymphocyte absolute values at the end of operation and postopertive 72 h in the two groups were significantly lower than those before operation (P<0 .05) ,but the peripheral blood CD3+ and CD3+CD8+ lym‐phocyte absolute values at the end of operation and postopertive 72 h in the treatment group were significantly higher than those in the control group(P<0 .05) .With the postoperative recovery ,the VAS cscores in the two groups all showed the significant decreasing trend(P<0 .05) ,but the VAS scores 24 ,72 h after surgery in the treatment group were significantly lower than those in the control group (P< 0 .05) .In the treatment group ,postoperative exhaust time ,hospitalization time and liquid diet time were significantly less than those in the control group (P<0 .05) .The postoperative wound bleeding ,wound infection and lung infection and other complications in the treatment group were significantly lower than those in the control group(P<0 .05) .Conclusion Dexmedetomidine conduces to adjust the immunologic derangement after esophageal cancer radical operation ,alleviate pain ,has good safety and deserves to be promoted and applied .