摘要
目的观察右美托咪定对乳腺癌根治术患者的应用效果及对免疫功能的影响。方法选取2016年3月—2018年3月我院收治的女性乳腺癌根治术患者109例为研究对象。按照是否应用右美托咪定进行麻醉前诱导分为观察组73例和对照组36例。观察组麻醉诱导前给予右美托咪定,对照组不用右美托咪定。2组均行全麻手术。观察并比较2组手术情况(手术时间、术中出血量、睁眼时间和拔管时间),采用视觉模拟(VAS)评分评估疼痛程度(苏醒即刻、术后24、48h)。检测麻醉诱导前(T1)、术中60 min(T2)、和术后24 h(T3)的CD3、CD4、CD8、CD4/CD8变化情况。观察2组不良反应发生情况。结果观察组睁眼时间和拔管时间均短于对照组(P<0.05),苏醒即刻、术后24 h的VAS评分低于对照组(P<0.05)。2组T2和T3时间段CD3、CD4、CD4/CD8低于T1时,CD8高于T1时(P<0.05),但观察组CD3、CD4、CD4/CD8高于对照组、CD8低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论乳腺癌根治术应用右美托咪定可缓解术后急性疼痛,避免抑制免疫功能,不良反应发生率低。
Objective To observe effectiveness of Dexmedetomidine in application of patients undergoing radical mastectomy and its effect on immune function. Methods A total of 109 women with radical mastectomy admitted during March 2016 and March 2018 were divided into observation group ( n =73) and control group ( n =36) according to whether or not using Dexmedetomidine for preanesthesia induction. Observation group was given Dexmedetomidine before anesthesia induction, while control group did not be given Dexmedetomidine before anesthesia induction. Both groups were given general anesthesia operation. In two groups, operative time, intraoperative bleeding volume, opening eye time and extubation time were observed and compared;visual analogue scales (VAS) score was used to assess pain degrees at the time of awakening and in 24 h and 48 h after operation;changes of CD3, CD4, CD8 and CD4/CD8 levels before induction of anesthesia (T1), in the 60 th minutes during operation (T2) and in the 24 th h after operation (T3) were detected;incidence rates of adverse reactions were observed. Results In observation group, opening eye time and extubation time were significantly shorter ( P <0.05), and VAS scores at the time of awakening and in 24 h and 48 h after operation were significantly lower than those in control group ( P <0.05). In T2 and T3, CD3, CD4 and CD4/CD8 levels were significantly lower, while CD8 levels were significantly higher than those in T1 in two groups ( P <0.05);in observation group, CD3, CD4 and CD4/CD8 levels were significantly higher, while CD8 level was significantly lower than those in control group ( P <0.05). Incidence rate of adverse reactions in observation group was significantly lower than that in control group ( P <0.05). Conclusion Dexmedetomidine in application of radical mastectomy may relieve postoperative acute pain and avoid immunosuppression with low incidence rate of adverse reactions.
作者
徐亮
王冬梅
苗海敏
李小玲
唐晓雷
韩明强
XU Liang;WANG Dong-mei;MIAO Hai-min;LI Xiao-ling;TANG Xiao-lei;HAN Ming-qiang(Department of Anesthesiology, Traditional Chinese Medicine of Handan City, Handan, Hebei 056001, China;Department of Oncology, People's Hospital of Xingtai City, Xingtai, Hebei 054001, China)
出处
《解放军医药杂志》
CAS
2019年第5期101-104,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省卫生厅科研基金项目(20191865)
关键词
麻醉
乳腺癌
右美托咪定
T淋巴细胞
疼痛
Anesthesia
Breast neoplasms
Dexmedetomidine
T-lymphocyte
Pain
