不同麻醉方法对癌症患者T细胞亚群及NK细胞的影响

目的 比较不同麻醉方法对结肠癌根治术患者围术期免疫功能的影响.方法 将60例结肠癌患者随机分成两组,A组采用全凭静脉麻醉,B组采用静脉麻醉复合硬膜外阻滞,分别于麻醉前（T0）、切皮后（T1）、术毕（T2）、术后1 d（T3）、以及术后3 d（T4）从颈内静脉抽取血液,测定CD3＋、CD4＋、CD8＋和自然杀伤细胞（NK细胞）.结果 与T0时点相比较,T1、T2时点两组患者CD3＋、CD4＋、CD8＋和NK细胞均降低;B组在T3时点CD3＋、CD4＋、CD＋和NK细胞有所恢复,A组在T4时点CD3＋、CD4＋、CD8＋和NK细胞有所恢复.结论 结肠癌患者术中和术后存在免疫功能抑制,全麻复合硬膜外阻滞的患者术后免疫功能恢复较早.

The Effect of Different Anesthesia on T-Lymphocyte Subsets and NK Cell in Patients with Cancer

Objective To investigate the effects of different anesthesia on T - lymphocyte subsets and NK cell in patients with cancer. Methods Sixty cancer patients were randomly divided into two groups： group A received general anesthesia, group B underwent general anesthesia plus epidural anesthesia. Venous blood samples were collected for the measurement of T -lymphocyte subsets and NK cell before the induction（T0）, after skin incision（T1）, end of operation（T2）,24h（T3）and 72h（T4）after surgery. Result The levels of CD3^＋ ,CD4^＋ , CD8^＋ and NK cell were all decreased at T1, T2 in both of groups. Its increased at T3 in group A and its increased at T4 in group B. Conclusion General anesthesia combined with epidural anesthesia is an ideal anesthet- ic method for cancer patient.