全麻加用硬膜外阻滞对乳腺癌患者血液流变学、应激反应及全T淋巴细胞亚群的影响分析

Effects of General Anesthesia combined with Epidural Block on Hemorheology,Stress Response and T Lymphocyte Subsets of Patients with Breast Cancer

目的分析全麻加用硬膜外阻滞对乳腺癌患者血液流变学、应激反应及全T淋巴细胞亚群的影响。方法随机选取乳腺癌患者63例,随机分为2组:一组全麻加用硬膜外阻滞组(A组,30例),一组全麻组(B组,33例),统计分析两组患者的血液流变学、应激反应及全T淋巴细胞亚群。结果麻醉中A组患者的血浆粘度、全血粘度低切变率、中切变率、高切边率均显著低于B组(P<0.05),红细胞压积、红细胞聚集指数、刚性指数均显著低于B组(P<0.05),红细胞变形指数显著高于B组(P<0.05)。T1、T2、T3、T4时A组患者的血清GH水平均显著低于B组(P<0.05);T1、T2、T3时A组患者的血清PRL水平均显著低于B组(P<0.05);T1、T2时A组患者的血清Cor水平均显著低于B组(P<0.05)。T1、T2时A组患者的CD3+值均显著高于B组(P<0.05);T1、T2、T3、T4时A组患者的CD4+值均显著高于B组(P<0.05);T1、T2时A组患者的CD4+/CD8+均显著高于B组(P<0.05)。结论全麻加用硬膜外阻滞较全麻更能有效改善乳腺癌患者血液流变学、应激反应及全T淋巴细胞亚群。

Objective To explore the effects of general anesthesia combined with epidural block on hemorheology,stress response and T lymphocyte subsets of patients with breast cancer.Methods 63 cases of breast cancer patients were randomly divided into 2 groups,group A was general anesthesia combined with epidural block(30 cases),and group B was general anesthesia(33 cases),the hemorheology,stress response and T lymphocyte subsets were analyzed.Results During anesthesia,the plasma viscosity and the low shear rate,medium and high shear rate of blood viscosity of patients in group A were significantly lower than those of group B(P<0.05),the hematocrit,erythrocyte aggregation index and rigidity index in group A were significantly lower than those of group B(P<0.05),the erythrocyte deformation index in group A was significantly higher than that of group B(P<0.05).At T1,T2,T3 and T4,the serum GH levels of patients in group A were significantly lower than those of group B(P<0.05);At T1,T2 and T3,the serum PRL levels of patients in group A were significantly lower than those of group B(P<0.05);At T1 and T2,the serum Cor levels of patients in group A were significantly lower than those of group B(P<0.05).At T1 and T2,the CD3+of patients in group A were significantly higher than those of group B(P<0.05);At T1,T2,T3 and T4,the CD4+of patients in group A were significantly higher than those of group B(P<0.05);At T1 and T2,the CD4+/CD8+of patients in group A were significantly higher than those of group B.Conclusion The general anesthesia combined with epidural block is more effective on hemorheology,stress response and T lymphocyte subsets of patients with breast cancer.