地佐辛联合氟比洛芬酯麻醉在胃癌根治术中的镇痛效果及对患者认知功能和细胞免疫功能的影响

Analgesic Effects of Dezocine Combined with Flurbiprofen Axetil Anesthesia in the Treatment of Gastrectomy and Its Influence on Cognitive Function and Cellular Immune Function of Patients

目的探讨地佐辛联合氟比洛芬酯麻醉在胃癌根治术中的镇痛效果及对患者认知功能和细胞免疫功能的影响。方法将行胃癌根治术的患者72例随机分为两组,每组36例,均行全凭静脉复合麻醉,镇痛泵配方分别为地佐辛30 mg+氟比洛芬酯150 mg(研究组)和芬太尼0.01 mg/(kg·d)(对照组)。比较两组疼痛评分、镇静评分、不良反应发生情况以及外周静脉血T淋巴细胞亚群CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平。结果两组患者术后12 h、24 h和48 h的视觉模拟评分法(VAS)评分和Ramsay镇静评分比较差异无统计学意义(P>0.05);研究组术后12 h、24 h和48 h简易智力状态检查量表(MMSE)评分显著高于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为13.88%,显著低于对照组的30.55%,差异有统计学意义(P<0.05);术毕和术后1 d两组CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平较治疗前显著降低(P<0.05),两组间比较差异无统计学意义(P>0.05);术后3d研究组CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平与治疗前比较,差异无统计学意义(P>0.05),而对照组显著低于治疗前和研究组,差异有统计学意义(P<0.05)。结论地佐辛联合氟比洛芬酯麻醉在胃癌根治术中的具有理想的镇痛效果,与芬太尼比较,术后患者认知功能恢复更好,不良反应更轻,细胞免疫功能恢复更快,综合疗效优于芬太尼麻醉。

Objective To explore the analgesic effects of dezocine combined with flurbiprofen axetil anesthesia in the treatment of gastrectomy and its influence on cognitive function and cellular immune function of patients.Methods A total of 72 patients undergoing radical gastrectomy for gastric cancer were randomly divided into 2 groups,with 36 patients in each group,which were given total intravenous anesthesia.The analgesic pump formulations were Dizosin 30 mg+Flurbiprofen Ester 150 mg(study group)and Fentanyl 0.01 mg/(kg·d)(control group).Pain score,sedation score,incidence of adverse reactions and levels of CD3^+,CD4^+,CD8^+,CD4^+/CD8^+in peripheral venous blood T lymphocyte subsets were compared between the 2 groups.Results There was no significant difference in VAS score and Ramsay sedation score between the 2 groups at 12 h,24 h and 48 h after operation(P>0.05);the scores of MMSE in the study group at 12 h,24 h and 48 h after operation were significantly higher than those in the control group(P<0.05);the incidence of adverse reactions in the study group was 13.88%,which was apparently lower than the control group of 30.55%(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in the 2 groups after operation and 1 d after operation were significantly lower than those before treatment(P<0.05),and there was no significant difference between the 2 groups(P>0.05).There was significant difference in the levels of CD3^+,CD4^+,CD4^+/CD8^+in the study group 3 days after operation(P<0.05).Conclusion Dezocine combined with flurbiprofen axetil anesthesia has ideal analgesic effect in radical gastrectomy of gastric cancer,compared with fentanyl.The postoperative cognitive function of the patients recovered better,the adverse reactions were lighter,the cellular immune function recovered faster,and the comprehensive curative effect was better than fentanyl anesthesia.