右美托咪定对原发性肝癌TACE术患者镇痛效果、炎症因子及T淋巴细胞亚群的影响

Effects of Dexmedetomidine on Analgesic Effect,Inflammatory Factors and T Lymphocyte Subsets in Patients undergoing TACE Operation for Primary Liver Cancer

【目的】探讨右美托咪定对原发性肝癌经皮肝动脉化疗栓塞(TACE)术患者镇痛效果、炎症因子及T淋巴细胞亚群的影响。【方法】本院收治的72例拟行TACE术治疗的原发性肝癌患者,随机分为对照组(给予盐酸氢吗啡酮^(+)托烷司琼镇痛)和观察组(给予盐酸氢吗啡酮^(+)托烷司琼^(+)右美托咪定镇痛),每组36例。对比两组患者视觉疼痛模拟评分(VAS)、炎症因子、T淋巴细胞亚群水平及患者围术期不良反应发生情况。【结果】两组患者术前各项指标比较,差异无统计学意义(P>0.05)。术后6 h、12 h及24 h两组患者VAS评分均高于术前(P<0.05);且观察组术后6 h、12 h及24 h VAS评分均低于对照组(P<0.05)。术后24 h,两组患者γ干扰素(IFN-γ)、转化生长因子(TGF-β)水平较术前均降低(P<0.05);且观察组低于对照组(P<0.05)。与术前相比,术后24 h两组患者血清CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均降低(P<0.05),观察组患者术后24 h CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05);两组患者术后24 h CD8^(+)水平比较,差异均无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异均无统计学意义(P>0.05)。【结论】右美托咪定对原发性肝癌TACE术患者的镇痛作用较好,可调节炎性因子水平,改善患者的免疫功能,且安全可靠。

【Objective】To investigate the effect of dexmedetomidine on the analgesic effect,inflammatory factors and T lymphocyte subsets of patients undergoing percutaneous transhepatic arterial chemoembolization(TACE)for primary liver cancer.【Methods】A total of 72 patients with primary liver cancer who were to be treated with TACE were randomly divided into the control group(administration of hydromorphone hydrochloride^(+)tropisetron^(+)saline)and the observation group(administration of hydromorphone hydrochloride^(+)tropisetron^(+)dexmedetomidine),each group had 36 cases of patients.The levels of visual pain simulation score(VAS),inflammatory factors and T lymphocyte subsets were compared between the two groups.Adverse reactions in the two groups of patients during the perioperative period were compared as well.【Results】There was no significant difference in VAS scores between the two groups of patients before operation(P>0.05).The VAS scores of the two groups of patients at 6 h,12 h and 24 h after surgery were higher than those before surgery(P<0.05).The VAS scores of the observation group at 6 h,12 h and 24 h after operation were lower than those of the control group(P<0.05).At 24 h after surgery,the levels of IFN-γand TGF-βin the two groups decreased(P<0.05).The levels of IFN-γand TGF-βat 24 h in the observation group were lower than those in the control group(P<0.05).Compared with preoperatively,serum CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)ratio all decreased(P<0.05).The CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)ratio of the observation group were higher than those of the control group at 24 h after the operation(P<0.05).There was no difference in the CD8^(+)levels of the two groups at 24 h after the operation.Statistical significance(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).【Conclusion】Dexmedetomidine has a better analgesic effect on patients undergoing TACE for primary liver cancer,which can regulate the level of inflammatory factors and improve the patient's immune function.It is safe and reliable.