摘要
目的观察采用布托啡诺术后镇痛对于胃癌根治术患者T淋巴细胞亚群及NK细胞的影响。方法将全麻下行择期胃癌开腹根治术的患者42例,随机分为对照组(21例)和观察组(21例)。术后病人自控静脉镇痛采用背景剂量+负荷剂量的输入模式。背景剂量:观察组给予布托啡诺0.2μg/(kg.h),对照组采用芬太尼0.2μg/(kg.h);负荷剂量:0.2μg.kg-1。镇痛时间持续24h。流式细胞术检测手术前,手术结束时,术后24h,72h及7d,外周血中CD3+,CD4+,CD8+及NK细胞的比例并计算CD4+/CD8+比值。结果手术结束时,两组患者外周血CD3+,CD4+及NK细胞的比例较术前降低,但CD8+增高。观察组各淋巴细胞亚群比例从术后24h起开始回复,至72h基本恢复至术前水平;而对照组术后24h仍处于抑制状态,至72h才开始回复。结论对胃癌根治术患者使用布托啡诺术后镇痛不抑制T淋巴细胞亚群及NK细胞的增殖能力,对于控制肿瘤的复发、转移,改善远期预后,都有积极意义。
OBJECTIVE To observe the influence of the postoperative analgesic with buprenorphine on the cell immunity of gastric cancer patients during perioperative period.METHODS 42 patients who undergoing surgery for gastric cancer with general anesthesia were randomly and equally divided into two groups（21）.The observation group was pumped with butorphanol 0.2μg/（kg·h） as background dose which last for 24h,while the control group with fentanyl 0.2μg/（kg·h）.Loading dose of both groups was 0.2μg·kg-1.Collected blood samples before surgery,instantly after surgery,at 24h and 72h and 7d after surgery,respectively.Then analyzed percentage of NK cell,and T-cell subgroups with CD3＋,CD4＋,CD8＋ by flow cytometry.Ratio of CD4＋/CD8＋were also draw our attention.RESULTS Instantly after surgery,Both T-cell subgroups with CD3＋,CD4＋ and NK cell decreased remarkably compared with preoperative,while inversely of CD8＋.In observation group,all of these cell subgroups recuperated at 24h after surgery and restored soundly at 72h.Immune cells were persistent inhibited to 72h in control group and restoration about one week.CONCLUSION Butorphanol used in postoperative analgesic do not inhibit the cell immunity of gastric cancer patients.It is beneficial in tumor manipulation and prognosis improvement.
出处
《海峡药学》
2012年第6期68-70,共3页
Strait Pharmaceutical Journal
