低剂量舒芬太尼复合地佐辛对老年胃癌患者认知功能及细胞免疫功能的影响

目的 探讨低剂量舒芬太尼复合地佐辛对老年胃癌患者术后认知功能及细胞免疫功能的影响.方法 选择96例老年胃癌患者,随机平均分为观察组与对照组.2组给予相同的麻醉方法,术后镇痛观察组给予低剂量舒芬太尼复合地佐辛,对照组给予舒芬太尼.观察2组患者术前1 d、术后6 h、12 h、24 h、48 h、72 h的MMSE评分;术前1天(T0)、术后12 h(T1)、24 h(T2)、48 h(T3)的T淋巴细胞亚群、NK细胞及术后的不良反应.结果 与术前1天对比,观察组及对照组在术后6 h、12 h、24 h的MMSE评分明显降低,组间对比差异无统计学意义,MMSE评分术后72 h恢复至术前.与T0时间点对比,对照组的CD3+、CD4+、CD4+/CD8+、NK细胞在T1、T2、T3点的评分明显降低;观察组的CD3+、CD4+、CD4+/CD8+、NK细胞在T1、T2点均显著降低,T3点与T0点无差异.在T1、T2、T3点时,观察组的CD3+、CD4+、CD4+/CD8+、NK细胞均明显高于对照组,P均<0.05.2组的T1、T2、T3点的CD8+与T0对比,组内及组间对比均无统计学差异,P>0.05.观察组的不良反应发生率明显低于对照组,P<0.05.结论 老年胃癌患者术后应用低剂量舒芬太尼复合地佐辛,不增加术后早期认知功能障碍的风险,有利于术后免疫功能的恢复,不良反应较少,值得临床推广应用.

Influence of Low dose Sufentanil Combined with Dezocin on the Cognitive Function and Cellular Immune Function of Elderly Patients with Gastric Cancer

Objective To investigate the influence of low dose sufentanil combined with dezocin on the cognitive func -tion and cellular immune function of elderly patients with gastric cancer.Methods 96 cases with gastric cancer were chosen and randomly divided into the observation group and the control group ,the 2 group were given same anesthesia method ,the observation group were given low dose sufentanil combined with dezocin postoperative analgesia ,the control group were given sufentanil post-operative analgesia.The MMSE score 1day before surgery,6 h,12 h,24 h,48 h,72 h after surgery were observed,the T phocyte subpopulation,NK cell before anesthesia(T0)1 day before surgery,12 h(T1),24 h(T2),48 h(T3) after surgery were observed, the adverse reactions after surgery were observed.Results The MMSE score of the observation group and the control group 6 h, 12 h,24 h after surgery were obvious lower than 1 day before surgery.The CD3 +、CD4 +、CD4 +/CD8 +、NK cells of the control group at T1,T2,T3 were significant lower than T0,the CD3 +、CD4 +、CD4 +/CD8 +、NK cell of the observation group at T1,T2 were significant lower than T0,the T3 and T0 had no significant difference ,the CD3 +、CD4 +、CD4 +/CD8 +、NK cell of the obser-vation group at T1、T2、T3 were higher than the control group ,P<0.05.The CD8 +of the 2 groups had no significant difference with T0,which within and between groups had no significant difference ,P>0.05.Adverse reactions of the observation group were obvious lower than the control group ,P<0.05.Conclusion The low dose sufentanil combined with dezocin of elderly patients with gastric cancer after surgery can not increase the cognitive function risk after surgery ,and it is worthy of immune function re-covery ,with fewer adverse reactions ,it is worthy of clinical application.