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《不同麻醉方法及麻醉深度對(duì)胃癌手術(shù)患者細(xì)胞免疫功能的影響》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。
1、不同麻醉方法及麻醉深度對(duì)胃癌手術(shù)患者細(xì)胞免疫功能的影響【摘要】目的:探討不同麻醉方法及麻醉深度對(duì)胃癌手術(shù)患者細(xì)胞免疫功能的影響,為臨床手術(shù)采取合理的麻醉方法提供科學(xué)根據(jù)。方法：將80例胃癌手術(shù)患者隨機(jī)分成靜吸復(fù)合麻醉組（A組）和單純靜脈麻醉組（B組），每組40例，組內(nèi)再各分為深麻醉組（AH組,BH組）和淺麻醉組（AL組,BL組）。深麻醉組和淺麻醉組腦電雙頻指數(shù)（bispectralindex，BIS）分別為35～50和55～68。兩組分別于麻醉前、術(shù)畢及術(shù)后72h檢測(cè)外周血T淋巴細(xì)胞亞群及NK細(xì)胞數(shù)量。結(jié)果:術(shù)畢各組CD3+、CD4+、CD4+/CD8
2、+及NK細(xì)胞數(shù)量均較麻醉前下降（P<0.05）,同種麻醉方法AL組、BL組較AH組、BH組下降明顯（P<0.05）；術(shù)后72h各組各項(xiàng)指標(biāo)均恢復(fù)至麻醉前水平；在相同時(shí)段不同麻醉方法深、淺麻醉組之間各指標(biāo)差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：靜吸復(fù)合麻醉與單純靜脈麻醉均可影響患者的細(xì)胞免疫功能，但深麻醉狀態(tài)較淺麻醉狀態(tài)影響小，可能與患者應(yīng)激反應(yīng)有關(guān)?！娟P(guān)鍵詞】麻醉，全身·麻醉，吸入·麻醉，靜脈內(nèi)·胃腫瘤·T淋巴細(xì)胞·殺傷細(xì)胞，天然【ABSTRACT】Objective:Tostudytheeffectsofdifferentanest
3、hesiamethodsandanesthesiadepthonpostoperative8changesinT-lymphocytesubsetsandNKcellsinthepatientsundergoingoperationofstomachcarcinoma.Methods:Eightypatientswithstomachcarcinomawererandomlydividedintotwogroups.ThepatientsingroupAreceivedintravenous-inhalationanesthesiaandthosein
4、groupBtotalintravenousanesthesia.Thosepatientsofeachgroupweredividedintoadequateanesthesiagroup(groupAH,groupBH)andinadequateanesthesiagroup(groupAL,groupBL).IngroupAHandgroupBHbispectralindex(BIS)wasbetween35and50,55and68ingroupALandgroupBL.Peripheralvenousbloodsampleweretakenb
5、eforeanesthesia,attheendofoperation,andat72hafteroperationfordeterminationofT-lymphocytesubsetsCD3+,CD4+,CD4+/CD8+andNKcellsbyflowcytometer.Results:CD3+,CD4+,CD4+/CD8+andNKcellsdecreasedattheendofoperationinallgroupscomparedwiththosebeforeanesthesia(P<0.05).At72hafteroperatio
6、n,thevaluesincreasedtothelevelbeforeanesthesiainallgroups.ThevaluessignificantlydecreasedattheendofoperationingroupALandgroupBLthaningroupAHandgroupBH(P<0.05).ThedifferencesofthosevaluesbetweengroupAHandgroupBHwerenostatisticalsignificance,neitherbetweengroupALandgroupBL(P>
7、;0.05).Conclusions:Generalanesthesiahastransientinhibitoryeffectsoncellularimmunefunctionin8patientsundergoingstomachcarcinomaoperation.【KEYWORDS】Anesthesia,general·Anesthesia,inhalation·Anesthesia,intravenous·Stomachneoplasms·T-lymphocytes·Killercells，natural 惡性腫瘤患者機(jī)體多存在免疫功能異常
8、，外科手術(shù)導(dǎo)致的應(yīng)激反應(yīng)會(huì)引起機(jī)體免疫功能的下降，從而提高術(shù)中細(xì)胞微栓的存活率，有利于腫瘤細(xì)胞
