不同麻醉方法对乳腺良性肿瘤切除患者免疫功能的影响

目的 比较硬膜外麻醉和局部浸润麻醉下乳腺良性肿瘤切除患者免疫功能的改变.方法 30例乳腺良性肿瘤切除患者,随机均分成硬膜外组和局麻组,分别给予1%利多卡因15 ml或0.5%利多卡因30 ml,麻醉前(T1)及麻醉后30 min(T2)、60 min(T3)及90 min(T4)各取外周静脉血1.5 ml,测定T细胞亚群CD3 、CD4 、CD8 、(CD3 CD4 )/(CD3 CD8 )和自然杀伤细胞(NK细胞).结果 与T1时比较,硬膜外组在T2、T3时CD4 和(CD3 CD4 )/(CD3 CD8 )值均显著升高(P<0.05),NK细胞显著降低(P<0.05),T4与T1时比较差异无统计学意义.CD3 和CD8 在各时点无显著变化.局麻组在各时点T淋巴细胞亚群及NK细胞均无显著变化.结论 硬膜外麻醉对乳腺良性肿瘤切除患者免疫功能产生一过性影响.

The effects of different anesthesia on immune function in patients undergoing benign breast tumor surgery

Objective To observe the effects of different anesthesia on immune function in the patients undergoing benign breast tumor operation.Methods Thirty patients were randomly divided into local anesthesia group(L,0.5% lignocaine 30 ml) and epidural anesthesia group(E,1.0% lignocaine 15 ml).Peripheral vein blood was obtained before anaesthesia(T1),at 30 min(T2),60 min(T3) and 90 min(T4) during anaesthesia for detecting CD3 ,CD4 ,CD8 ,(CD3 CD4 )/(CD3 CD8 )and natural killer cells by flow cytometry.Results In group E,at T2 and T3,CD4 and(CD3 CD4 )/(CD3 CD8 )increased and natural killer cells decreased significantly compared with those at T1(P<0.05).The values of CD3 and CD8 were not significantly changed during anaesthesia compared with those before anaesthesia.In group L,the values of all measurements above were not significantly different between before and during anaesthesia.Conclusion Epidural anesthesia has some transitory inhibiting effects on the immune function in patients undergoing benign breast tumor surgery.