文章摘要
魏大明,王守义,阙红波,赵 艳,戴 红.瑞芬太尼联合右美托咪定对乳腺癌根治术患者镇痛效果及围术期T淋巴细胞亚群的影响[J].,2022,(6):1093-1097
瑞芬太尼联合右美托咪定对乳腺癌根治术患者镇痛效果及围术期T淋巴细胞亚群的影响
Remifentanil Combined with Dexmedetomidine on the Analgesic Effect of Breast Cancer Patients Undergoing Radical Mastectomy and the Influence of Perioperative T Lymphocyte Subsets
投稿时间:2021-07-24  修订日期:2021-08-20
DOI:10.13241/j.cnki.pmb.2022.06.020
中文关键词: 乳腺癌  根治手术  T淋巴细胞  右美托咪定
英文关键词: Breast cancer  Radical surgery  T lymphocytes  Dexmedetomidine
基金项目:安徽省普通高校重点实验室项目(MZKF202002)
作者单位E-mail
魏大明 安徽中医药大学第三附属医院麻醉科 安徽 合肥 230001 weidaming9999@163.com 
王守义 安徽中医药大学第三附属医院麻醉科 安徽 合肥 230001  
阙红波 安徽中医药大学第三附属医院麻醉科 安徽 合肥 230001  
赵 艳 安徽中医药大学第三附属医院麻醉科 安徽 合肥 230001  
戴 红 安徽中医药大学第三附属医院麻醉科 安徽 合肥 230001  
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中文摘要:
      摘要 目的:研究瑞芬太尼联合右美托咪定在乳腺癌根治术患者手术过程中的镇痛效果,以及围手术期对患者外周血T淋巴细胞亚群的影响。方法:收集2018年到2020年进行根治术手术的68例乳腺癌患者作为研究对象,随机数表法分为对照组和研究组,各34例。对照组给予瑞芬太尼进行麻醉诱导的维持,研究组患者给予瑞芬太尼和右美托咪定进行麻醉诱导和维持。比较两组患者麻醉时间、手术时间、手术出血量,术后苏醒时间、拔管时间以及不良反应发生率,并比较两组患者手术后2 h、8 h和24 h VAS和Ramsay评分以及麻醉诱导前、术中1 h和术后24 h外周血T淋巴细胞亚群变化。结果:两组患者年龄、麻醉时间、手术时间、手术出血量以及手术后2 h、8 h和24 h VAS和Ramsay评分无显著差异(P>0.05);研究组患者术后苏醒时间、拔管时间以及不良反应发生率均显著低于对照组患者(P<0.05)。麻醉诱导前,两组患者外周血CD3+、CD4+、CD8+及CD4+/CD8+T淋巴细胞比例无显著差异(P>0.05);手术中1 h和术后24 h,研究组患者外周血CD3+、CD4+以及CD4+/CD8+细胞比例均高于对照组患者,而外周血CD8+细胞比例低于对照组患者,差异均显著具体统计学意义(P<0.05)。结论:乳腺癌根治术患者使用瑞芬太尼联合右美托咪定进行麻醉诱导和维持不会影响患者镇痛效果,但可以降低患者术后不良反应发生率,并影响患者围术期T淋巴细胞免疫功能。
英文摘要:
      ABSTRACT Objective: To study the effect of remifentanil combined with dexmedetomidine on the analgesic effect and T lymphocyte subsets in breast cancer undergoing radical mastectomy. Methods: A total of 68 breast cancer patients who undergoing radical mastectomy from 2018 year to 2020 year were selected in our study. We used the random number table method to divide them into the control group and the study group. Patients in control group was given remifentanil for anesthesia induction and maintenance, and Patients in research group was given remifentanil and dexmedetomidine for anesthesia induction and maintenance. We compared the anesthesia time, operation time, surgical blood loss, postoperative wake-up time, extubation time, and incidence of adverse reactions in the two groups of patients. And we also compared the VAS and Ramsay scores at 2 h, 8 h and 24 h after surgery, as well as the T lymphocyte subsets in peripheral blood before induction of anesthesia, at 1 hour during operation and at 24 hours after surgery. Results: There was no significant difference between the two groups of patients in age, anesthesia time, operation time, surgical blood loss, and VAS and Ramsay scores at 2 h, 8 h and 24 h after surgery(P>0.05); The postoperative recovery time, extubation time and the incidence of adverse reactions in the study group were significantly lower than those in the control group(P<0.05). Before induction of anesthesia, there was no significant difference in the ratio of CD3+, CD4+, CD8+ and CD4+/CD8+T lymphocytes in peripheral blood between the two groups (P>0.05); At 1h during operation and 24 h after operation, the ratio of CD3+, CD4+ and CD4+/CD8+ cells in the peripheral blood of the study group was higher than that of the control group, while the ratio of CD8+ cells in the peripheral blood was lower than that of the control group. The difference was significant and statistically significant(P<0.05). Conclusion: The use of remifentanil combined with dexmedetomidine for induction and maintenance of anesthesia in patients undergoing radical mastectomy will not affect the patient's analgesic effect, but it can reduce the incidence of postoperative adverse reactions and affect the patient's perioperative T lymphocytes Immune Function.
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