【摘要】 目的探讨静吸复合麻醉用于卵巢癌根治术的效果及对患者T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+的影响。方法选择行卵巢癌根治术的患者80例,随机分为常规麻醉组(患者进行全凭静脉麻醉)和复合麻醉组(患者进行静吸复合麻醉),各40例,分别于麻醉前、清醒后、术后1 d、术后3 d流式细胞术检测患者外周血中T淋巴细胞亚群的变化并进行比较和分析。结果 (1)与常规麻醉组相比,静吸复合麻醉组患者术后苏醒以及自主呼吸用时均显著缩短(P <0.05),术中麻醉所使用的阿托品和去氧肾上腺素的剂量均显著减少(P <0.05)。(2)与麻醉前相比,术后0 h 2组患者CD3+、CD4+、CD4+/CD8+均显著降低,而术后1～3 d以上指标则较术后0 h显著升高(P均<0.001)。麻醉前2组T淋巴细胞亚群比例差异均无统计学意义(P> 0.05),术后0 h～1 d CD3+、术后0 h CD4+以及术后0 h～3 d CD4+/CD8+复合麻醉组显著高于常规麻醉组,差异具有统计学意义(P均<0.05)。(3)静吸复合麻醉组患者术后不良反应发生率显著低于常规麻醉组(P <0.05)。结论应用静吸复合麻醉的卵巢癌根治术患者术中对麻醉药物需求量较少,苏醒用时短且术后并发症发生率较低,虽不可避免患者免疫功能相关T淋巴细胞亚群比例降低,但其影响程度相对较小,且患者免疫功能恢复较快。更多还原

【Abstract】 Objective To investigate the effect of intravenous inhalation combined anesthesia for radical operation of ovarian cancer and its influence on T3 lymphocyte subsets CD3 +,CD4 +,CD4 +/CD8 +. Methods 80 patients who underwent radical ovarian cancer surgery were randomly divided into conventional anesthesia group( patients underwent total intravenous anesthesia) and compound anesthesia group( patients underwent combined Intravenous-Inhalation Anesthesia),and for each of the40 patients,the changes of T lymphocyte subsets in the peripheral blood of patients were detected before,6 h,1 d,3 d,and 1 w after anesthesia and compared and analyzed. Results( 1) Compared with the conventional anesthesia group,patients in the static inhalation combined anesthesia group had significantly shorter wake-up time and spontaneous breathing time( P < 0. 05),and the atropine and phenylephrine doses used during the anesthesia were significantly reduced( P < 0. 05).( 2) Compared with before anesthesia,CD3 +,CD4 +,and CD4 +/CD8 + were significantly reduced in the 2 groups of patients at 0 h after surgery,and the indicators above 1-3 days were significantly higher than those at 0 h after surgery( all P < 0. 001); There was no significant difference in the proportion of T lymphocyte subsets between the 2 groups before anesthesia( P > 0. 05). CD3 + at 0 h to 1 d after operation,CD4 + at 0 h after operation and CD4 +/CD8 at 0 h to 3 d after operation,all the above indicators in the combined anesthesia group were significantly higher than conventional anesthesia group,the differences were statistically significant( all P <0. 05)( 3) The incidence of postoperative adverse reactions was significantly lower in patients in the static anesthesia combined anesthesia group than in the conventional anesthesia group( P < 0. 05). Conclusion Patients with radical ovarian cancer undergoing static suction combined anesthesia require less anaesthetic drugs during surgery,have shorter wake-up time and have a lower incidence of postoperative complications. The reason may be that although the application of the anesthesia method reduces the proportion of T lymphocyte subsets related to immune function of patients,the degree of influence is relatively small,and the patient’s immune function recovers quickly.更多还原