全麻复合硬膜外麻醉对老年食管癌患者围手术期T淋巴细胞亚群的影响

[目的]观察全麻复合硬膜外麻醉对老年食管癌患者围手术期T淋巴细胞亚群的影响.[方法]72例ASAⅠ～Ⅱ级择期行食管癌切除术的患者随机分成两组（n=36）：静脉全麻组（G组）和静脉全麻复合硬膜外阻滞组（GE组）.所有患者静脉全麻使用丙泊酚靶控输注,于麻醉前（T0）、术毕（T1）、术后d1（T2）、术后d3（T3）、术后d5（T4）5个时间点抽取肘静脉血5 mL测定两组T淋巴细胞亚群（CD3＋、CD4＋、CD8＋）的变化并比较两组患者不良反应.[结果]与T0相比较,两组患者T1和T2时刻外周血的CD3＋、CD4＋及CD4/CD8值均明显下降,且差异有显著性（P〈0.05）.与G组相比,GE组T3~T4时刻CD4及CD4/CD8明显上升,差异有显著性（P〈0.05）,不良反应无明显差别（P〉0.05）.[结论]全麻复合硬膜外麻醉较有利于促进老年食管癌患者围手术期T细胞亚群恢复正常.

Effect of General Anesthesia Combined with Epidural Anesthesia on T-lymphocyte Subsets in Elderly Patients with Esophageal Cancer in Peroperative Period

[Objective]To observe the impact of general anesthesia combined with epidural anesthesia on T- lymphocyte subsets in elderly patients with esophageal cancer in peroperative period. [Methods]Totally 72 ASA Ⅰ-Ⅱ patients scheduled for esophageal resection were randomly divided into intravenous anesthesia group（group G, n =36） and intravenous anesthesia combined with epidural anesthesia group（group GE, n=36）. All patients with intravenous anesthesia received target-controlled infusion of propofol. The 5mL venous blood before anesthe sia（T0 ）, at the endpoint of operation（T1 ）, postoperative dl （T2）, d3 （T3） and d5 （T4） was drawn to determine the changes of T-lymphocyte subsets（CD3, CD4, CD8） in two groups. The adverse effects were compared between two groups. CResultslCompared with To, CD3, CD4 and CD4/CD8 in two groups at T1 and T2 markedly de creased, and there was significant difference（ P 〈0.05）. Compared with group G, CD4 and CD4/CD8 in group GE at T3 ~ T4 obviously increased, and there was significant difference（ P〈d0.05）. There was no significant difference in adverse reactions（ P〉0.05）. [Conclusion] General anesthesia combined with epidural anesthesia is more conducive to promote the recovery of T-lymphocyte subsets in elderly patients with esophageal cancer in pero-perative period.