舒芬太尼自控静脉镇痛对肺癌切除术后患者血流动力学及免疫功能的影响

Influence of Sufentanil Patient-controlled Intravenous Analgesia on Postoperative Hemodynamics and Immune Function in Patients with Lung Cancer Resection

目的:探讨舒芬太尼自控静脉镇痛对肺癌切除术后患者血流动力学及免疫功能的影响。方法:选择2009年2月-2014年2月在我院行肺叶切除术的非小细胞肺癌(NSCLC)患者110例,依据随机数字表法将全部患者分为对照组和观察组,每组55例。术后观察组患者接受舒芬太尼自控静脉镇痛,对照组接受芬太尼自控静脉镇痛,观察两组患者血液动力学指标和免疫功能指标的差异。结果:镇痛1 d后,观察组全血粘度、全血还原粘度、红细胞聚集指数(RAI)和毛细血管血浆粘度均显著低于对照组(均P<0.05),CD4+T细胞、IL-2含量观察组显著高于对照组(P<0.05),CD8+T细胞、IL-6、IL-10含量观察组均显著低于对照组(均P<0.05)。结论:肺癌根治术后采用舒芬太尼自控静脉镇痛可显著调节患者血流动力学指标,改善机体免疫功能,可推广临床实践。

Objective： To explore the influence of sufentanil patient-controlled intravenous analgesia on postoperative hemodynamics and immune function in patients with lung cancer resection.Methods： A total of 110 patients with non-small cell lung cancer（NSCLC）,who underwent lobectomia pulmonalis in Seventh Affiliated Hospital of Zunyi Medical College from February 2009 to February 2014,were selected and randomly divided into observation group（n=55） and control group（n=55）.The observation group was treated with sufentanil patient-controlled intravenous analgesia after surgery,while the control group,fentanyl patient-controlled intravenous analgesia after surgery.Then observed the difference of hemodynamics indexes and immune function indexes between the two groups.Results： The whole blood viscosity,whole blood reduction viscosity,red blood cell aggregation index（RAI） and capillary plasma viscosity in the observation group 1 d after analgesia were significantly lower than those in the control group（P〈0.05）.Contents of IL-2 and CD4＋T cell in the observation group were significantly higher than those in the control group,and the contents of IL-6,IL-10 and CD8＋T cells were significantly lower than those in the control group（P〈0.05）.Conclusion： Sufentanil patient-controlled intravenous analgesia can significantly improve the hemodynamics indexes and enhance immune function,which is worthy of clinical application.