右美托咪定不同给药时间对腹腔镜结肠癌根治术围术期细胞免疫功能的影响

Effect of dexmedetomidine administered at different time on peri-and postoperative cellular immune function with laparoscope colorectal cancer radical resection

目的评价右美托咪定不同给药时间对腹腔镜结肠癌根治术围术期细胞免疫功能的影响。方法选择行腹腔镜下结肠癌根治术患者60例,按随机数字表法分为B组、M组、P组,每组20例。三组患者均泵注右美托咪定1μg·kg-1,15 min泵注完成。B组为手术开始前30 min;M组为手术结束前30 min;P组为手术结束时。分别于术前(T0)、术毕(T1)、术后12 h(T2)、术后24 h(T3)各时间点监测患者外周血T细胞亚群及NK细胞水平。结果与T0相比,B组和P组患者T1、T2时的CD3+、CD4+及NK水平均明显降低(P<0.05);与B组相比,P组T1时CD3+(51.4±11.8)及CD4+(24.6±6.2)明显降低(P<0.05)。结论腹腔镜结肠癌根治术结束前30 min持续泵注右美托咪定可有效改善患者围术期的细胞免疫功能,值得临床推广。

Objective To evaluate the efficacy of dexmedetomidine administered at different time on peri-and postoperative cellular immune function with laparoscope colorectal cancer radical resection. Methods 60 patients received thoracoscopic sympathectomy were randomly and equally divided into 3 groups. All of patients received dexmedetomidine 1 μg·kg-1 in 15 minutes. Patients in group B received 30 minutes before operation start. Meanwhile,group P and group M received immediately and 30 min before the operation ending. Peripheral blood sample were collected before the anesthesia（T0）,the time points of operation ending（T1）,12 h（T2） and24 h after operation（T3） for determination of plasma CD3^＋,CD4^＋and NK level. Results Compared with T0,level of CD3＋,CD4＋and NK of group B and P was decreased significantly at T1 and T2（P〈0. 05）. Except that,compared with group B,level of CD3＋（51. 4 ± 11. 8）,CD4＋（24. 6 ± 6. 2） in group P were significantly decreased at T1（P〈0. 05）. Conclusion Dexmedetomidine administered 30 min before laparoscope colorectal finish can effectively improve postoperative cellular immune function.