托烷司琼对手术后曲马多自控静脉镇痛患者免疫功能的影响

Effect of Tropisetron Hydrochloride on Immune Function of Tramadol for Postoperative Patientcontrolled Intravenous Analgesia

目的:观察托烷司琼对手术后曲马多自控静脉镇痛患者免疫功能的影响。方法:40例患者随机分为两组,术毕给负荷量后接PCIA泵;并于麻醉前、术毕、术后24、48 h检测CD3+、CD4+、CD8+、CD4+/CD8+及CD16+、CD56+/CD45+的变化。结果:对照组恶心呕吐发生率明显高于观察组(P<0.05);两组CD3+、CD4+淋巴细胞在术毕、术后24 h和48 h均较麻醉前明显降低(P<0.05),CD16+、CD56+/CD45+、CD4+/CD8+术毕及术后24 h也低于麻醉前(P<0.05);对照组在术后24 h CD16+、CD56+/CD45+、CD3+、CD4+、CD4+/CD8+明显增高(P<0.05);对照组在术后48 h CD16+、CD56+/CD45+、CD4+/CD8+已恢复到麻醉前水平。结论:预防性应用托烷司琼,能有效地减轻曲马多引起的恶心呕吐,但减弱其免疫保护功能。

Objective To investigate the effect of Tropisetron Hydrochloride on the immune function of tra-madol for postoperative patient-controlled intravenous analgesia. Methods Forty patients were randomly as-signed into two groups, connecting the PCIA pump after given the load quantity. Blood samples were collectedbefore induction of anaesthesia and after operation for 0 h, 24 h, 48 h, respectively. The T-lymphocyte subsetsand natural killer cells（NK）were measured by flow cytometry. Results The incidences of nausea and vomitingwere higher in control group than those in observation group（P 〈 0.05） . In both groups,the amounts of CD3＋ andCD4＋lymphocytes decreased significantly at 0 h, 24 h and 48 h after operation than before anaesthesia（P〈 0.05）.the amounts of NK cells（CD16＋、CD56＋/CD45＋） and CD4＋/CD8＋ also decreased significantly at 0 h and 24 h afteroperation than before anaesthesia（P 〈 0.05）. Compared to the observation group ,the amounts of CD16＋,CD56＋/CD45＋, CD3＋, CD4＋ and CD4＋/CD8＋ increased significantly at 24 h after operation（P 〈 0.05）. In control group,the amounts of CD16＋, CD56＋/CD45＋ and CD4＋/CD8＋ recovered to preanaesthesia level at 48 h, while in observa-tion group, they were still lower than preanaesthesia levels（P 〈 0.05）. Conclusion Tropisetron Hydrochloridereduces the incidence of vomiting induced by tramadol but not beneficial to recover the cell-immunity of pa-tients suffering from gastric cancer surgery.