不同麻醉方法对子宫颈癌手术患者免疫功能的影响

目的探讨不同麻醉方法对子宫颈癌手术患者免疫功能的影响。方法选择子宫颈癌手术患者72例,随机分为两组,全麻组(A组),硬膜外麻醉组(B组),每组36例。用不同麻醉方法对患者进行麻醉。分别于麻醉前、麻醉后2h、术后1、3、5、7d抽取静脉血,用流式细胞仪测定T淋巴细胞亚群及自然杀伤细胞(NK细胞)的数量。结果与麻醉前相比,两组患者麻醉后2hCD3 、CD4 、CD4 /CD8 、NK细胞的数量均有所下降(P<0·05);术后1d各指标下降显著(P<0·05,P<0·01)。组间比较,麻醉后2h至术后3d虽然两组患者的CD3 、CD4 、CD4 /CD8 、NK细胞的数量都较麻醉前有所下降,但A组下降显著大于B组。结论硬膜外麻醉用于子宫颈癌手术,对于保护患者围术期的免疫功能有一定优越性。

Effects of different anesthesia methods on immune function in patients undergoing operation of cervical cancer

Objective To explore the effects of different anesthesia methods on postoperative change in T lymphocyte subsets and NK cells in the papients undergoing conventional operation of cervical cancer.Methods Seventy-two patients with cervical cancer were randomly divided into general anesthesia group (group A)and epidural anesthesia group (group B) . Peripheral venous blood samples were taken before anesthesia,at 2h after anesthesia,and on the 1st,3rd,5 th and 7 th postoperative day for determination of subsets of T-lymphocyte CD3 ,CD4 ,CD4 /CD8 and NK cells by flow cytometer. Results CD3 ,CD4 ,CD4 /CD8 and NK cells decreased at 2h after anesthesia in the two groups compared with those before anesthesia .The values further decreased in group A(P<0.01) and group B (P<0.05) on the 1 s t postoperative day. The values had a little increase on the 3 rd postoperative day in the two groups,but it still lower than those before anesthesia.On the 5 th postoperative day,the values increased to the level of before anesthesia in group B,and it still lower than those before anesthesia in group A.On the 7 th postoperative day,CD3 ,CD4 ,CD4 /CD8 and NK cells returned to the pre-anesthesia levels in both groups.Conclusion The two different anesthesia methods have transient inhibitory effects on cellular immune function in patients undergoing conventional operation of cervical cancer intra-and-postoperation .Epidural block is better than general anesthesia for protecting cellular immune function.