硬膜外和静脉自控镇痛法对癌痛患者免疫功能的影响

The effection of epidural and intravenous patient-control analgesia to immune function of patient with cancer pain

目的:评价硬膜外和静脉两种自控镇痛方法对癌痛患者免疫功能的影响和镇痛效果。方法:36例癌痛患者随机分为硬膜外组(E组)和静脉组(I组),每组18例,分别使用硬膜外自控镇痛(PCEA)和静脉自控镇痛(PCIA)术,于镇痛前、镇痛后1、3、5d分别采集静脉血测定T淋巴细胞亚群CD3+、CD4+、CD8+及白细胞介素2(IL-2),并计算CD4+/CD8+比值,同时评价和比较两组的镇痛效果。结果:两组的CD3+、CD4+、CD8+、CD4+/CD8+及IL-2于镇痛后均上升,E组上升较I组快(P<0.05);两种镇痛方法均达到良好的镇痛效果。结论:硬膜外和静脉两种镇痛方法对癌痛患者的免疫功能均有改善作用,与PCIA相比,PCEA对免疫功能的改善作用更好,更有利于患者免疫功能的恢复;两种镇痛方法均可获得良好的镇痛效果。

Objective ： To compare the effect and response to analgesics of epidural and intravenous patient - control analgesia（ PCEA and PCIA） to immune function of patient with cancer pain. Methods： Thirty six cancer pain patients were randomly divided into 2 groups. 18 patients in each group. Group E used PCEA and group I used PCIA. The immune index CD3 ^＋ , CIM ^＋ , CD8 ^＋ , IL - 2 of 36 patients were tested before analgesia and after analgesia 1,3,5days, and measure the CIM ^＋/CD8 ^＋ , while comment and compare the response to analgesics of the two groups. Results： The immune index CD3 ^＋ , CIM ^＋ , CD8 ^＋ , CIM ^＋/CD8 ^＋ , IL -2 after analgesia in two groups both grew. And group E grew faster than group Ⅰ （ P 〈 0.05 ）. Both methods of analgesia had good response to analgesics. Conclusion： Both epidural and intravenous patientcontrol analgesia（ PCEA and PCIA） to immune function of patient with cancer pain have good response and can improve the immune function . Compare to PCIA , PCEA can improve the immune function better . Two methods of analgesia have good effect of analgesics.