不同麻醉方式对小细胞肺癌围手术期免疫功能的影响

Effect of different anesthesia methods on perioperative immune function in small cell lung cancer

目的:观察全麻和全麻复合硬膜外阻滞麻醉对小细胞肺癌患者围手术期免疫功能的影响。方法:前瞻性将2013年6月至2015年6月期间60例确诊为小细胞肺癌的患者根据麻醉方式的不同分为对照组和观察组,对照组行常规全身麻醉,观察组行全身麻醉复合硬膜外阻滞麻醉,对比两组患者围手术期T细胞和NK细胞水平变化情况。结果:两组患者在T1、T2时点较T0时点CD3+、CD4+水平逐渐降低、CD8+水平逐渐增高、CD4+/CD8+和NK细胞水平逐渐降低,比较差异均有显著统计学意义(P<0.05),组间各时点免疫细胞水平比较差异无统计学意义(P>0.05);T3、T4、T5时点免疫细胞水平逐渐恢复,T5时点观察组各项免疫细胞水平基本恢复至T0时刻水平,对照组仍低于T0时刻,但均明显高于T2时刻水平,组内和组间比较差异均有显著统计学意义(P<0.05)。结论:全麻联合硬膜外阻滞麻醉对小细胞肺癌根治术患者围手术期免疫功能影响较轻微,术后恢复较快,可作为首选的麻醉方式。

Objective：To obsmwe the effect of combined epidural block anesthesia on perioperative immune function in small cell lung cancer. Methods ： Total of 60 patients with small cell lung cancer were divided into 2 groups according to the different anesthesia methods during June 2013 to June 2015. The control group received routine general anesthesia. The patients in obsmwation group were treated with combined epidural block anesthesia. The changes of T cells and NK cells were compared between the two groups. Results：In the two groups, the levels of CD3 ＋ , CD4 ＋ , CD8 ＋, CD4＋/CD8 ＋ and NK at T1 , T： were gradually decreased, the difference was statistically significant （P 〈 0.05 ） , At T3 , T4 and T5 , the level of immune cells gradually recovered. The level of immune cells in the observation group was significantly restored to TO at T5 level,while the control group was significantly higher than that of T2 , and the difference was statistically significant（P 〈 0.05 ）. Conclusion：The effect of general anesthesia combined with epidural block anesthesia on perioperative immune function in patients with small cell carcinoma of lung cancer is slight, the recovery is faster, can be used as the first choice of anesthesia.