Exp Ther Med:不同的麻醉与镇痛方式对危重症患者免疫功能和血清肿瘤标记物含量的影响

2017-11-15 易菁 “罂粟花”微信号

探究不同的麻醉与镇痛方式对肿瘤切除术患者免疫功能和血清肿瘤标记物含量的影响。

背景与目的:探究不同的麻醉与镇痛方式对肿瘤切除术患者免疫功能和血清肿瘤标记物含量的影响。

方  法:本研究纳入郑州大学第二附属医院2015年9月-2016年8月期间择期行肿瘤切除术的患者76名,随机分为对照组和观察组(n=38),其中对照组采用全身麻醉和术后静脉麻醉药物镇痛,观察组采用全身麻醉联合硬膜外麻醉以及术后硬膜外麻醉镇痛。分别采集麻醉前30min(T1)、手术2h(T2)、手术结束即刻(T3)、术后24h(T4)以及后72h(T5)时点的静脉血,应用流式细胞计数检测T淋巴细胞亚型(CD3+,CD4+,CD8+,CD4+/CD8+)和自然杀伤(NK)细胞的活细胞比例,免疫荧光技术检测术前术后24h时的癌胚抗原,糖链抗原199,糖链抗原125,神经元特异性烯醇化酶以及细胞角蛋白19的含量。

结  果:对照组CD3+,CD4+,CD8+,CD4+/CD8+的含量T3-T5时点低于T1时点(P<0.05)。虽然观察组CD3+的含量T3时点同样低于T1时点,但T4和T5时点与T1时点的无显着差异(P<0.05)。T2-T5时点观察组CD3+,CD4+,CD8+,CD4+/CD8+的含量显着高于对照组,T4时点观察组CD3+,CD4+的含量显着高于对照组,T5时点观察组CD4+/CD8+的含量显着高于对照组(P<0.05)。两组患者不同时点的CD8+细胞和NK细胞含量以及术后24h时的肿瘤标记物含量并无显着差异。

结  论:本研究的结果显示,尽管两组患者不同时点的肿瘤标记物含量无差异,但采用全身麻醉联合硬膜外麻醉和术后硬膜外麻醉镇痛方式比采用全身麻醉和术后静脉麻醉药物镇痛方式对肿瘤切除术患者的免疫功能影响更小。

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    2018-08-18 wjywjy
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    2017-11-17 zhaojie88
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