盐酸羟考酮2种给药方法对结肠癌术后免疫功能的影响

The Influences on Postoperative Immunological Function of Colon Cancer Patients Due to Two Different Routes of Administration of Oxycodone Hydrochloride

为探讨不同给药途径下盐酸羟考酮注射液对结肠癌根治术术后患者免疫功能的影响，将结肠癌根治术80例患者随机分为A组和B组各40例，均采用硬膜外复合全身静脉麻醉，予以咪达唑仑、舒芬太尼、依托咪酯、苯磺顺阿曲库铵诱导，术中静脉持续泵入丙泊酚、瑞芬太尼、苯磺顺阿曲库铵以及硬膜外间断注射利多卡因维持。A组手术结束时硬膜外注射3mg盐酸羟考酮（3mL），静脉注射3mL生理盐水；B组手术结束时静脉注射3mg盐酸羟考酮（3mL），硬膜外注射3mL生理盐水，2组分别于注射试剂前（T0）、注射试剂后0．5h（T1）、注射试剂后6h（T2）、注射试剂后12h（T3）、注射试剂后24h（T4）取静脉血，以流式细胞术测定T淋巴细胞亚群和NK细胞的数量变化。结果显示，A、B2组患者T1、T2、T3、T4的T淋巴细胞亚群和NK细胞数量较T0比均下降，T2降到最低，T3开始逐渐恢复。T1、T2、T3、T4A组T淋巴细胞数和NK细胞数均高于B组。结果表明，盐酸羟考酮注射液硬膜外给药与静脉给药中对结肠癌根治术术后患者免疫功能均有抑制作用，但是前者比后者对患者的免疫功能影响较小。

This study was to explore the influences on postoperative immunological function of colon cancer patients due to two different administration routes of oxycodone hydrochloride,randomly divided the 80 pa- tients to be subject to colon cancer radical procedure into group A and group B,40 cases for each;both groups all adopted epidural compound intravenous general anesthesia inducing with Midazolam,Sufentanil, Etomidate, Cisatracurium Besilate; continuously intravenous pumping Propofol, Remifentanil, Cisatracuri- um Besilate and incontinuously epidural injecting Lidocaine for maintainance.At the end of operation, group A was injected 3 mg of oxyeodone hydrochloride （3 mL） epidurally and 3 mL of normal saline intravenous- ly,meanwhile group B 3 mg of oxycodone hydrochloride （3 mL） intravenously,3 ml of normal saline epi- durally;befor injection（T0 ）, and at 0.5 h（T1 ）, 6 h（T2 ）, 12 h（T3 ） and 24 h（T4 ） after injection took venous blood and detected their T lymph-cell subset and NK ceil count change by using flow cytometry. As re- sults, in two groups at T1 ,T2,T3,T4 two cell count were lower than that at T0 ,at T2 to the lowest, from T3 started recovering gradually ; but T1 , T2 ,T3, T4 group A was all higher than group B in two cell connts. Results show that two routes of administration of oxycodone hydrochloride all have inhibition on patient＇s immunological function,but epidural administration has less influence than intravenous one.