不同全麻方式对腹腔镜结肠癌切除术患者围麻醉期T 淋巴细胞亚群的影响研究

Impact of different general anesthesia on T-lymphocyte subsets in patients underwent laparoscopic colon cancer resection

摘要:

目的 研究不同全麻方式对腹腔镜结肠癌切除术患者围麻醉期T 淋巴细胞亚群的影响。 方法 选取2008 年3 月-2012 年6 月于该院接受腹腔镜结肠癌切除术的患者80 例，按照全麻方式的不同 分为3 组，接受静脉全麻的患者共28 例（A 组）；接受吸入全麻的患者共25 例（B 组）；接受静吸复合全 麻的患者共27 例（C 组）。检测3 组患者围麻醉期的T 淋巴细胞亚群水平并进行对照研究。结果 3 组 患者全麻后均出现CD3+、CD4+ 和CD8+ 水平降低，B 组的CD4+/CD8+ 和NK 细胞水平均明显降低，C 组 的CD4+/CD8+ 明显降低。B 组患者T1、T2 的各指标均明显低于A 组，C 组患者T1 的CD3+ 和CD8+ 水平明 显低于A 组，T2 除NK 细胞外其他各指标均明显低于A 组，另外C 组患者T1 的CD8+ 明显低于B 组，NK 细 胞明显高于B 组，T2 的CD4+ 明显高于B 组。结论 静脉全麻对于腹腔镜结肠癌切除术患者围麻醉期T 淋巴 细胞亚群影响最小，对免疫功能的影响最为轻微。

Abstract:

Objective To study the impact of different general anesthesia on T-lymphocyte subsets in patients underwent laparoscopic colorectal resection. Methods 80 patients with laparoscopic colorectal cancer resection were selected from March 2008 to June 2012. According to the difference of general anesthesia, there were 28 patients (Group A). There were 27 patients (group C) who underwent general anesthesia. Patients of the three groups were examined for the level of T lymphocyte subsets during anesthesia. Results CD3+, CD4+ and CD8+ levels were significantly decreased in all the three groups after general anesthesia, CD4+/CD8+ and NK cells in group B were significantly decreased, and CD4+/CD8+ in group C was significantly decreased. The levels of T1 and T2 in group B were significantly lower than those in group A, and the levels of CD3+ and CD8+ in group C were significantly lower than those in group A, and the other indexes except T2 were significantly lower than those of group A, and group C T1 CD8+ was significantly lower than that in group B, NK cells were significantly higher than those in group B, and CD4+ in T2 was significantly higher than that in group B. Conclusion Intravenous general anesthesia has the least effect on T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer resection, and the effect on immune function is the slightest.