| 胡灼军 郭翠 单东海 陈夏平 尹晓旭.曲马多、吗啡术后自控镇痛对食管癌患者细胞免疫功能的影响[J].,2015,15(34):6731-6733 |
| 曲马多、吗啡术后自控镇痛对食管癌患者细胞免疫功能的影响 |
| The Effects of Tramadol, Morphine in Postoperative Patient-controlledEpidural Analgesia on Cellular Immune Function of Patientswith Esophageal Cancer |
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| DOI： |
| 中文关键词: 食管癌 术后镇痛 曲马多 吗啡 细胞免疫功能 |
| 英文关键词: Esophageal cancer Postoperative analgesia Tramadol Morphine Cellular immune function |
| 基金项目:卫生部医药卫生科技发展研究中心基金项目(W2013R39) |
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| 中文摘要: |
| 目的：比较曲马多、吗啡对食管癌术后患者的镇痛疗效以及对机体免疫功能的影响。方法：将本院50 例行食管癌手术患者随
机分成对A 组和B 组，A 组接受硬膜外吗啡镇痛，B 组接受硬膜外曲马多镇痛，常规监测心电图（ECG）、无创血压（BP）、心率
（HR）、血氧饱和度（SPO2）、呼气末二氧化碳分压(PETCO2）。记录两组患者不同时间点视觉模拟疼痛（VAS）评分、不良反应发生
率、外周血T 淋巴细胞亚群(CD3+、CD4+、CD8+)、NK 细胞的变化。结果：两组患者均得到满意的术后镇痛效果，术后1d，A、B两组
患者外周血T淋巴细胞亚群、NK 细胞的水平较术前降低（P<0.05），且A 组降低幅度明显大于B 组（P<0.05）；术后2d，A 组外周
血T 淋巴细胞亚群、NK 细胞的水平虽有所升高，但仍较术前降低（P<0.05），B 组CD3+、CD4+、CD8+及NK细胞水平恢复至术前水
平；术后3d，A 组上述指标恢复至麻醉前水平。结论：曲马多在镇痛的同时对机体外周血T 淋巴细胞亚群和NK细胞水平影响较
小，减轻了麻醉对细胞免疫功能的抑制效应。 |
| 英文摘要: |
| Objective:To compare the postoperative analgesia effects of tramadol and morphine and their impacts on immune
function for patients with esophageal cancer.Methods:A total of 50 patients who had the routine esophageal cancer surgery in our
hospital were randomly divided into group A and group B. Patients in group A took the epidural morphine analgesia, and patients in
group B adopted epidural tramadol analgesia. All adopted the regular monitoring of the electrocardiogram (ECG), noninvasive blood
pressure (BP) and heart rate (HR), blood oxygen saturation (SPO2), partial pressure of carbon dioxide in endexpiratory (PETCO2).
Recorded the visual analog pain score (VAS) at different time points, the incidence of adverse reactions, the changes of peripheral blood
T lymphocyte subsets (CD3 +, CD4 +, CD8 +) and NK cells of the two groups of patients.Results:Both of the two groups of patients had
satisfied postoperative analgesia effects. Compared to the preoperative, the levels of peripheral blood T lymphocyte subsets and NK cells
of the two groups reduced in 1 d after operation (P<0.05), and the reduction of group A was significantly greater than group B (P<0.05).
At 2 d after operation, the levels of peripheral blood T lymphocyte subsets and NK cells of group A was increased, but still lower than the
preoperative (P < 0.05); The CD3 +, CD4 +, CD8 + and NK cells in groupB recovered to the preoperative levels. At 3 d after operation, the
above-mentioned indexes of group A recovered to the levels before anesthesia.Conclusion:Tramadol had less affect on peripheral blood
T lymphocyte subsets and NK cells levels at the same time of analgesia, relieved the inhibition effects of anesthesia on the cellular
immune function. |
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