硬膜外复合静脉麻醉用于卵巢癌根治术的镇痛效果及对患者T淋巴细胞亚群、IL-2水平的影响

Analgesic effect of epidural compound intravenous anesthesia on ovarian cancer patients undwent total correction and its effect on the level of T lymphocyte subsets and IL-2 levels in patients

目的探讨硬膜外复合静脉麻醉用于卵巢癌根治术的镇痛效果,并观察其对患者T淋巴细胞亚群、白细胞介素-2(IL-2)水平的影响。方法抽取漯河市第二人民医院2018年1月至2019年7月收治的76例卵巢癌根治术患者为实验对象,依据不同的麻醉方式将入选患者分为观察组及对照组,每组38例,其中对照组行全身麻醉,观察组行硬膜外复合静脉麻醉。观察两组患者的镇痛效果、治疗前后的T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)、IL-2水平变化情况。结果对照组镇痛满意率(55.26%)低于观察组(97.37%),差异有统计学意义(χ^2=18.636,P<0.05)。观察组的术后镇痛泵按压次数为(6.45±1.52)次,低于对照组[(23.66±3.65)次];术后1 d,IL-2水平为(11.24±4.16)pg/ml,高于对照组[(8.94±3.96)pg/ml],术后3 d,观察组患者的CD3+、CD4+水平高于对照组[(57.39±7.39)%、(35.27±7.66)%比(51.48±7.47)%,(30.31±6.40)%],差异有统计学意义(P<0.05)。对照组总不良反应率(28.56%)与观察组(7.89%)比较,差异有统计学意义(χ^2=5.604,P<0.05)。结论硬膜外复合静脉应用于卵巢癌根治术中具有理想镇痛效果,有助于维持患者细胞因子水平稳定,能有效抑制细胞免疫功能。

Objective To investigate the analgesic effect of epidural compound intravenous anesthesia in patients with ovarian cancer underwent total correction,and observe its effect on the levels of T lymphocyte subsets,interleukin-2(IL-2)levels in patients.Methods A total of 76 patients with ovarian cancer treated in Second People’s Hospital of Luohe from January 2018 to July 2019 were selected as experimental subjects.According to different anaesthesia methods,the patients were divided into observation group(n=38)and control group(n=38).General anesthesia was performed in the control group and epidural combined intravenous anesthesia was performed in the observation group.The analgesic effect,the changes of T lymphocyte subsets(CD3^+,CD4^+,CD8^+,CD4+/CD8^+)and IL-2 levels before and after treatment of the two groups were compared.Results The satisfactory rate of analgesia in the control group(55.26%)was lower than that in the observation group(97.37%),the difference was statistically significant(χ^2=18.636,P<0.05).Postoperative analgesia pumps in the observation group[(6.45±1.52)times]was significantly lower than those in the control group[(23.66±3.65)times];1 day after operation,IL-2 level in the observation group[(11.24±4.16)pg/ml]was higher than those in the control group[(8.94±3.96)pg/ml].Three days after operation,CD3+,CD4+in the observation group were significantly higher than those in the control group[(57.39±7.39)%,(35.27±7.66)%vs.(51.48±7.47)%±(30.31±6.40)%],and the differences were statistically significant(P<0.05).The total adverse reaction rate of the control group(28.56%)was higher than that of the observation group(7.89%),the difference was statistically significant(χ2=5.604,P<0.05).Conclusions Epidural compound intravenous anesthesia has ideal analgesic effect in radical ovarian cancer surgery,which is helpful to maintain the stability of cytokine levels in patients,and effectively inhibit cellular immune function.