卵巢癌分期手术患者全身麻醉中右美托咪定的应用

Application of dexmedetomidine in general anesthesia inpatients with ovarian cancer undergoing staged surgery

目的探讨卵巢癌分期手术患者全身麻醉中右美托咪定的应用及对患者T淋巴细胞亚群水平的影响。方法选取卵巢癌手术患者50例,按照治疗方式分为对照组及观察组,各25例。观察组麻醉诱导前15 min注射右美托咪定,对照组静脉注射相同体积的生理盐水。在麻醉诱导15 min(T_(0)期)、手术结束后1 h(T_(1)期)及手术后24 h(T_(2)期)检测2组患者的炎症因子水平及T淋巴细胞亚群水平。结果2组患者T_(1)、T_(2)期的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平和核因子-κB(NF-κB)水平均高于T_(0)期,且对照组升高幅度大于观察组(P<0.05);2组患者的T淋巴细胞亚群水平与T_(0)期相比均下降,且对照组CD4+/CD8+水平降低幅度大于观察组(P<0.05)。结论卵巢癌分期手术患者全身麻醉中右美托咪定可有效发挥抗炎作用,抑制患者NF-κB水平的升高,同时降低患者的CD4+/CD8+,改善患者的T淋巴细胞亚群水平,从而改善患者的免疫功能。

Objective To investigate the application of dexmedetomidine in general anesthesia for ovarian cancer patients undergoing staging surgery and its effect on T lymphocyte subsets.Methods 50 cases of ovarian cancer surgery patients were selected and divided into control group and observation group according to the anesthesia method,with 25 cases in each group.Dexmedetomidine was injected 15 minutes before anesthesia induction in the observation group,and the control group was injected with the same volume of normal saline intravenously.The levels of inflammatory factors and T lymphocyte subsets in the 2 groups were measured 15 minutes after anesthesia induction(stage T_(0)),1 hour after surgery(stage T_(1)),and 24 hours after surgery(stage T_(2)).Results The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and nuclear kappa factor-B(NF-κB)in T_(1) and T_(2) were significantly higher than those in T_(0),and the increase in the control group was significantly higher than that in the observation group(P<0.05).The level of T lymphocyte subsets in the 2 groups decreased compared with the T_(0) stage,and the reduction of CD4+/CD8+ in the control group was greater than that in the observation group(P<0.05).Conclusion Dexmedetomidine under general anesthesia for ovarian cancer staging surgery can effectively play an anti-inflammatory role in increasing NF-κB,lowering CD3+/CD4+,improving T lymphocyte subsets,and improving the immune function of patients.