不同镇痛药物对直肠癌患者镇痛效果、免疫功能及预后的影响

The Influence of Different Analgesic Drug on Analgesic Effect,Immune Function and Prognosis in Patients with Rectal Cancer

目的探讨不同镇痛药物对直肠癌患者镇痛效果、免疫功能及预后的影响。方法选择82例全身麻醉下行腹腔镜下直肠癌手术的患者,根据患者入院先后顺序,分为吗啡组及地佐辛组,吗啡组术后给予吗啡自控镇痛,地佐辛组术后给予地佐辛自控镇痛,比较2组患者的VAS评分、不良反应总发生率,对比2组免疫细胞(CD3+、CD4+、CD8+、CD4+/CD8+值、NK细胞)情况,对比术后恢复情况及远期复发转移率。结果 2组的镇痛效果VAS评分无统计学意义,地佐辛组的总不良反应发生率明显低于吗啡组,地佐辛组的CD3+、CD4+、CD4+/CD8+、NK百分比恢复至术前水平的时间较吗啡组短,地佐辛组的术后肠道排气时间、术后进食时间、术后下床时间及肿瘤的远期复发转移率明显低于吗啡组。结论术后镇痛地佐辛效果确切,且对患者的免疫功能影响较小,可以缩短患者的术后恢复时间,同时降低远期复发转移率。

Objective To investigate the influence of different analgesic drug on analgesic effect,immune function and prognosis in patients with rectal cancer. Methods 82 cases with laparoscopic rectal cancer surgery were chosen and divided into morphine and dizocine groups,the morphine group were given morphine controlled analgesia. The dizocine group were given dizocine controlled analgesia,the VAS score,adverse reaction of the 2 groups were compared,the immue cell（ CD3＋ 、CD4＋ 、CD4＋/CD8＋ 、NK） were compared,recovery situation and forward recurrence rate of the 2 groups were compared. Results The VAS of the 2 groups had no significant difference,P 〉 0. 05,the total adverse reaction of dizocine group were obvious lower than morphine group,the recovery to preoperative level time of CD3＋ 、CD4＋ 、CD4＋/CD8＋ 、NK in dizocine group were shorter than morphine group,P 〈 0. 05. The postoperative bowel discharger time,postoperative feeding time,postoperative bed time and recurrence rate of tumor of dizocine group were obvious lower than morphine group. Conclusion Dizocine had graet efficacy in postoperative analgesia,and had less immue influence on patients,which could shortern the recovery time after surgery and decrease long-term recurrence rate.