右美托咪定对食管癌根治术后吗啡镇痛时细胞免疫功能的影响

Influence of Dexmedetomidine on Cellular Immune Function during Morphine Analgesia after Radical Resection of Esophageal Cancer

目的分析右美托咪定对食管癌根治术后吗啡镇痛时细胞免疫功能的影响。方法选择2018年1月至2018年12月我院收治的100例食管癌根治术患者,随机分为A组、B组各50例。患者完成手术后苏醒时移除气管导管。之后,若患者主诉疼痛,实施PCIA,A组使用0.48 mg/kg吗啡,B组使用0.48 mg/kg吗啡联合1μg/kg右美托咪定。比较两组的吗啡使用量、不良反应情况、T淋巴细胞亚群与NK细胞水平。结果T2、T3、T4时,B组的吗啡使用量低于A组(P<0.05)。B组的瘙痒、呕吐、恶心发生率低于A组(P<0.05)。两组患者T1、T2时的CD3+、CD4+、CD4+/CD8+与NK细胞水平低于T0时(P<0.05)。T2、T3、T4时,B组的CD3+、CD4+、CD4+/CD8+与NK细胞水平高于A组(P<0.05)。结论右美托咪定能够有效改善食管癌根治术后吗啡镇痛过程中细胞免疫功能,有助于促进患者疾病转归,值得临床推广。

Objective To analyze the influence of dexmedetomidine on cellular immune function during morphine analgesia after radical resection of esophageal cancer.Methods 100 patients with radical resection of esophageal cancer in our hospital from January 2018 to December 2018 were selected and randomly divided into group A and group B,with 50 cases in each group.The endotracheal tube was removed when the patients woke up after surgery.After that,if the patients complained of pain,PC IA was administered.Group A was given 0.48 mg/kg of morphine,and group B was given 0.48 mg/kg of morphine combined with 1/zg/kg of dexmedetomidine.The morphine usage,adverse reactions and levels of T lymphocyte subsets and NK cells were compared between the two groups.Results At T2,T3 and T4,the morphine usage of group B were lower than those of group A(P<0.05).The incidences of pruritus,vomiting and nausea of group B were lower than those of group A(P<0.05).At T3 and T2,the CD3+,CD4+,CD47CD8+and NK cell levels of the two groups were lower than those at To(P<0.05).At T2,T3 and T4,the CD3+,CD4+,CD47CD8+and NK cell levels of group B were lower than those of group A(P<0.05).Conclusions Dexmedetomidine can effectively improve the cellular immune function in the process of morphine analgesia after radical resection of esophageal cancer,and is helpful to promote the disease outcome of patients,which is worthy of clinical promotion.