PCIA及PCPB对肺癌根治术患者镇痛效果及免疫功能的影响

The Influence of PCIA and PCPB on Analgesic Effect and Immune Function of Lung Cancer Patients Treated with Radical Prostatectomy

目的探讨自控静脉镇痛及自控椎旁神经阻滞镇痛对肺癌根治术患者的镇痛效果及免疫功能的影响。方法 60例肺癌根治术患者,均给予相同的麻醉诱导及维持麻醉方法,根据不同的术后镇痛方法,分为自控静脉镇痛(A组)及自控椎旁神经阻滞镇痛(B组),观察两组患者T0、T1、T2、T3点的CD3^+、CD4^+、CD8^+、CD4^+/CD8^+及NK细胞,观察术后T2、T3的Ramsay镇静评分及恶心呕吐发生率。结果 T1、T2、T3点时A组的CD3^+、CD4^+、CD4^+/CD8^+、NK细胞明显低于T0点(P<0.05),CD8+明显高于T0点(P<0.05);T1、T2点时B组的CD3^+、CD4^+、CD4^+/CD8^+、NK细胞明显低于T0点(P<0.05),而T3点时CD3^+、CD4^+、CD4^+/CD8^+、NK细胞与T0点时相比无明显差异(P>0.05),CD3^+、CD4^+、CD4^+/CD8^+、NK细胞与A组相比差异显著(P<0.05)。两组术后Ramsay镇静评分对比无统计学意义(P>0.05),B组恶心呕吐发生率明显低于A组(P>0.05)。结论自控椎旁神经阻滞镇痛可以快速恢复肺癌手术患者术后的免疫功能,同时不引起患者术后恶心呕吐的发生,值得临床推广应用。

Objective To investigate the influence of PCIA and PCPB on analgesic effect and immune function of lung cancer patients treated with radical prostatectomy.Methods 60 cases of pulmonary carcinoma treated with radical resection were chosen and given the same anesthesia narcotic induction and maintenance methods,they were divided into controlled intravenous analgesia group（A group） and automatic control by the vertebral nerve block analgesia group（B group） according to different postoperative analgesia methods,CD3~＋、CD4~＋、CD8~＋、CD4~＋/CD8~＋ and NK cell of the 2 groups at T0、T1、T2、T3 were observed,the Ramsay score and nausea and vomiting incidence at T1、T2 were observed.Results CD3~＋、CD4~＋、CD4~＋/CD8~＋、NK cell of group A at T1、T2、T3 were lower than T0（P〈0.05）,CD8 ＋ was higher than T0（P〈0.05）.CD3~＋、CD4~＋、CD4~＋/CD8~＋、NK cell of group B at T1、T2 was lower than T0（P〈0.05）,while CD3~＋、CD4~＋、CD4~＋/CD8~＋、NK cell of group B at T1、T2 had no significant difference with T0（P〉0.05）,CD3~＋、CD4~＋、CD4~＋/CD8~＋、NK cell had significant difference with group A（P〈0.05）.Ramsay score after surgery of the 2 groups had no significant difference（P〉0.05）.Conclusion PCPB has rapid recovery of immune function of pulmonary carcinoma after radical resection,without nausea and vomiting,it is worthy of clinical application.