氟比洛芬酯复合曲马多术后镇痛对结直肠癌患者细胞免疫功能的影响

Impacts of postoperative analgesia using flurbiprofen combined with tramadol on cellular immune function among patients with colorectal cancer

目的：观察氟比洛芬酯复合曲马多用于结直肠癌患者术后静脉自控镇痛的效果及其对免疫功能的影响.方法：选取本院2009年6月至2010年3月结直肠癌患者30例,常规全麻下行结直肠癌根治手术.术后随机分成两组（n=15）,观察组应用氟比洛芬酯复合曲马多术后镇痛,对照组应用芬太尼.分别于术前24 h、术后72 h采用流式细胞术检测患者外周血淋巴细胞（T、Th、Ts、NK）绝对数值及对患者进行视觉模拟评分（VAS）.结果：两组患者各时点VAS评分差异无统计学意义（P〉0.05）;两组患者术前外周血T细胞、Th细胞、Ts细胞、NK细胞绝对数值对比差异无统计学意义（均P〉0.05）;观察组术后的T细胞、Th细胞、Ts细胞、NK细胞绝对数值均较对照组的高（均P〈0.05）.对照组患者术后较术前外周血T细胞、Th细胞、Ts细胞、NK细胞绝对数值均减低（均P〈0.05）,观察组的则变化不大.结论：氟比洛芬酯复合曲马多术后镇痛对机体细胞免疫功能无抑制作用,镇痛效果良好,更适用于肿瘤患者.

Objective： To evaluate the outcomes of patient-controlled intravenous postoperative analgesia using flurbiprofen combined with tramadol in patients with colorectal cancers and their impacts on immune function. Methods： Thirty patients with coloreetal cancer were selected to undergo coloreetal cancer radical resection under general anesthesia in our hospital from 2009 June to 2010 March and randomly divided into two groups after surgery （n = 15 each）. For the experimental group ,flurbiprofen combined with tramadol was used for postoperative analgesia,while fentanyl was used in the control group. Flow cytometry （FCM,） was employed to detect the absolute counts of peripheral blood lymphocytes （T,Th ,Ts and NK） at 24 hours before and 72 hours after operation respectively. Moreover,visual analogue scale （VAS） were recorded in the patients. Results：VAS scores showed no statistical difference between the two groups at all time spots （P 〉 0.05）. Furthermore,there was no significant difference in the absolute counts of T,Th,Ts and NK cells before operation between the two groups （ all P 〉0.05 ）. The postoperative absolute counts of T, Th, Ts and NK cells in the experimental group were higher than those in the control group （ all P 〈 0.05 ）. For the control group, the postoperative absolute counts of T,Th,Ts and NK cells were decreased as compared with those before operation （all P 〈 0.05 ）, while no significant changes were found in the experimental group. Conclusion：Flurbiprofen combined with tramadol, shows favorable effects in postoperative analgesia,and has no inhibitory action on immune function of the body, which may be more suitable for use in tumor patients.