羟考酮对直肠癌根治术术中麻醉患者CD4^+、CD8^+细胞及NK细胞水平的影响

Effects of oxycodone anesthesia on CD4^+,CD8^+ and NK cells in patients undergoing radical resection of rectal cancer

目的:探讨羟考酮对直肠癌根治术术中麻醉患者CD4^+、CD8^+细胞及NK细胞水平的影响。方法:将102例直肠癌根治术患者,按随机数字表法分为对照组和观察组,每组51例。对照组采用瑞芬太尼麻醉诱导,观察组采用羟考酮麻醉诱导。观察两组手术时间、术中出血量、肛门排气时间、进食时间、住院时间。于麻醉前(T0)、拔管时(T1)、术后24 h(T2)、术后48 h(T3)、术后72 h(T4)测定两组CD4^+、CD8^+、CD4^+/CD8^+的变化与NK细胞活性,并记录并发症发生率。结果:两组手术时间、术中出血量、肛门排气时间、进食时间、住院时间比较,差异无统计学意义(P>0.05)。观察组T2、T3时间点的CD4^+,T2、T3、T4时间点的CD8^+以及T3、T4时间点的CD4^+/CD8^+均显著高于对照组(均P<0.05)。观察组T2、T3、T4时间点的NK细胞活性显著高于对照组(P<0.05)。两组尿路感染、肠梗阻、切口感染、肺部感染、发热发生率比较均无明显差异(P>0.05)。结论:直肠癌根治术患者术中采用羟考酮麻醉诱导,能减轻免疫抑制,值得临床推广应用。

Objective:To investigate the effect of oxycodone on CD4^+,CD8^+ and NK cells in anesthetized patients undergoing radical resection of rectal cancer.Methods:102 patients with rectal cancer who underwent radical operation were randomly divided into a control group(n=51)and an observation group(n=51).The patients in the control group received remifentanil,while those in the observation group received oxycodone anesthesia induction.The operation time,intraoperative bleeding volume,anal exhaust time,feeding time and hospital days were compared.The CD4^+,CD8^+,CD4^+/CD8^+ and NK cell activity were measured before anesthesia(T0),at extubation(T1),24 hours(T2),48 hours(T3)and 72 hours(T4)after anesthesia,and the incidence of complications was recorded.Results:There was no significant difference in operation time,bleeding volume,anal exhaust time,feeding time and hospital days between the two groups(P>0.05).The CD4^+ at T2 and T3,and the CD8^+ at T2,T3 and T4,and CD4^+/CD8^+ at T3 and T4 in the observation group were significantly higher than those in the control group(P<0.05).The NK cell activity at T2-T4 in the observation group was higher than that in the control group(P<0.05).There was no significant difference in the incidence of urinary tract infection,intestinal obstruction,incision infection,pulmonary infection and fever between the two groups(P>0.05).Conclusion:Anesthesia induction by oxycodone could alleviate immunosuppression in patients undergoing radical resection.