超前镇痛管理对非小细胞肺癌患者围手术期免疫功能、预后的影响分析

[目的]探讨超前镇痛管理对非小细胞肺癌(NSCLC)患者围手术期免疫功能、预后的影响.[方法]将本院在2015年1月至2016年7月收治的NSCLC患者115例,按照随机、双盲的分配原则分为观察组58例和对照组57例.观察组采用超前镇痛管理,对照组采用常规镇痛模式.观察两组不同镇痛管理对围手术期免疫功能、预后的影响.[结果]观察组术后6 h、1 d、3 d的视觉模拟评分法(VAS)均明显低于对照组,其差异均有统计学意义(P<0.05);两组患者术前CD4+与CD8+水平比较差异无统计学意义(P>0.05),而术后均有不同程度下降,且明显低于术前,但观察组仍高于对照组,其差异均有统计学意义(P<0.05).观察组首次下床时间为(2.72±0.92)d,发生肺部感染、肺不张、胸腔积液分别为3.45%、0.00%、0.00%,均明显少于对照组,其差异有统计学意义(P<0.05).[结论]超前镇痛管理可更有效的减轻NSCLC患者围手术期的疼痛,并保护免疫功能,改善其预后,值得临床推广应用.

Effect of Preemptive Analgesia Management on Perioperative Immune Function and Prognosis of Patients with Non-Small Cell Lung Cancer

[Objective] To explore effect of preemptive analgesia management on perioperative immune function and prognosis of patients with non-small cell lung cancer.[Methods]All patients were divided into experimental group (n=58) and control group (n=57) according to the principle of randomized, double-blinded assignment of 115 cases of non-small cell lung cancer admitted in our hospital from January 2015 to July 2016.Preemptive analgesia was used in the experimental group and conventional analgesia was used in the control group.Our goal was to observe the effect of different analgesia management on perioperative immune function and prognosis.[Results]The visual simulation scores (VAS) of the two groups were observed 6h, 1d, 3d after operation.The score of the experimental group was significantly lower than that of the control group (P<0.05).There was no significant difference in CD4+ and CD8+ levels between the two groups before operation (P>0.05).The levels of CD4+ and CD8+ in the two groups after surgery were significantly lower than those before operation, but the CD4+ and CD8+ levels in the experimental group were still higher than those in the control group, and the difference was statistically significant (P<0.05).The first time that patient got out the bed for activities in the experimental group was (2.72 ± 0.92) d,and the rate of lung infection, atelectasis, pleural effusion were 3.45 %, 0.00 %, 0.00 %, respectively, all significantly less than the control group (P<0.05).[Conclusion] Preemptive analgesia management can more effectively reduce the perioperative pain in patients with non-small cell lung cancer, protect the immune function, and improve the prognosis of postoperative effect.It is worth promoting.