瑞芬太尼复合丙泊酚麻醉对非小细胞肺癌根治术患者免疫功能及术后瞻妄的影响

【目的】探讨瑞芬太尼复合丙泊酚麻醉对非小细胞肺癌(NSCLC)根治术患者外周血T淋巴细胞、皮质醇(Cor)、血糖及术后瞻妄的影响。【方法】本院拟实施肺癌根治术的90例NSCLC患者,随机分为两组,各45例;观察组采取瑞芬太尼复合丙泊酚麻醉、对照组采取芬太尼复合丙泊酚麻醉。比较两组患者术前、术后2h患者外周血中T淋巴细胞亚群、血清Cor、血糖水平及术后瞻妄的发生率。【结果】两组患者的手术时间相比较差异无显著性(P>0.05);观察组的丙泊酚用量显著低于对照组(P<0.05)。术前观察组和对照组的外周血T淋巴细胞、血清Cor、血糖水平相比较差异无显著性(P>0.05);术后2h观察组的外周血中CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组(P<0.05),CD8⁺测定值低于对照组(P<0.05);术后2h,观察组的血清Cor、血糖水平低于对照组(P<0.05)。观察组术后48h内的瞻妄发生率为6.67%(3/45),明显低于对照组的22.22%(10/45)(P<0.05)。【结论】瑞芬太尼复合丙泊酚麻醉对NSCLC根治术患者T淋巴细胞亚群、Cor、血糖水平的影响更小,患者术后发生瞻妄的情况更少。

Effect of Remifentanil Combined with Propofol Anesthesia on Immune Function and Postoperative Prognosis of Patients with Non-small Cell Lung Cancer Undergoing Radical Operation

【Objective】To investigate the effects of remifentanil combined with propofol anesthesia on peripheral blood T lymphocyte,cortisol(COR),blood glucose and postoperative prognosis in patients with non-small cell lung cancer(NSCLC)undergoing radical operation.【Methods】A total of 90 NSCLC patients planned to undergo radical surgery for lung cancer in our hospital were selected,and randomly divided to two group with 45 cases each.The experimental group was given propofol intravenous anesthesia combined with epidural anesthesia,and the control group was given propofol Intravenous anesthesia;the incidence of T lymphocyte subsets,Cor,blood glucose,and postoperative delusion of the two groups of patients before and 2 hours after the operation were compared.【Results】There was no significant difference in operation time between the two groups(P>0.05);the dosage of propofol in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the levels of peripheral blood T lymphocytes,serum Cor and blood glucose between the observation group and the control group before operation(P>0.05);the levels of CD3⁺,CD4⁺,CD4⁺/CD8⁺in the observation group 2 hours after operation were higher than those in the control group(P<0.05),and the measured value of CD8⁺was lower than that in the control group(P<0.05);the levels of serum cor and blood glucose in the observation group 2 hours after operation were lower than those in the control group(P<0.05).The incidence of delusion within 48 hours in the observation group was 6.67%(3/45),which was significantly lower than 22.22%(10/45)in the control group(P<0.05).【Conclusion】Remifentanil combined with propofol anesthesia has less influence on T lymphocyte,Cor and blood glucose levels of patients with NSCLC radical operation,and the incidence of postoperative delusion is less.