两种不同的麻醉方法对贲门癌患者围手术期T淋巴细胞亚群的影响

目的 研究两种不同麻醉方法对贲门癌患者围手术期T淋巴细胞亚群的影响.方法 32例择期行贲门癌根治术患者按随机数字表法分为全身麻醉组和硬膜外阻滞复合全身麻醉组(复合麻醉组),每组16例.分别于麻醉前、麻醉后、术毕、术后1 d、术后3 d检测外周血T淋巴细胞亚群的变化.结果 两组患者于麻醉后、术毕、术后1 d CD3、CD4、CD8及CD4/CD8均较麻醉前下降(P<0.05),术后3 d复合麻醉组CD3、CD4、CD8及CD4/CD8接近麻醉前水平(60.75±4.22)%、(39.65±3.64)%、(25.90±1.17)%、1.57±0.15](P>0.05),而全身麻醉组各项指标仍低于麻醉前(55.83±5.20)%、(35.15±5.65)%、(23.00±1.03)%、1.47±0.35](P<0.05),两组术后3 d比较差异均有统计学意义(P<0.05).结论 硬膜外阻滞复合全身麻醉能减轻围手术期应激反应及麻醉药物对T淋巴细胞亚群的抑制.

Effect of different anesthetic techniques on perioperative changes in T-lymphocyte subsets in patients with cardia cancer

Objective To observe the effects of different anesthetic techniques on T-lymphocyte subsets in patients with cardia cancer. Methods Thirty-two patients undergoing elective radical operation for cardia cancer who had been average assigned into two groups by random digits table, group Ⅰ :general anesthesia;group Ⅱ :epidural anesthesia combined with general anesthesia (16 cases in each group).Peripheral blood T-lymphocyte subsets were measured before induction, after anesthesia, end of operation, 1d,3 d after operation. Results CD3,CD4,CD8 and CD4/CD8 all decreased in two groups after anesthesia,end of operation and 1 d after operation than before induction (P < 0.05). The index almost returned to the baseline values at 3 d after operation in group Ⅱ (60.75 ± 4.22 )%, (39.65 ± 3.64)%, (25.90 ± 1.17 )%,1.57 ±0.15](P >0.05),while in group Ⅰ still lower (55.83 ±5.20)%, (35.15 ±5.65)%, (23.00 ±1.03 )%, 1.47 ± 0.35 ](P< 0.05 ). The two groups ontrast had significant deviation at 3 d after operation (P<0.05). Conclusion Epidural anesthesia combined with general anesthesia can reduce depression of Tlymphocyte subsets induced by surgical trauma and anesthesia.