资源描述：
《不同麻醉方法及麻醉深度对胃癌手术患者细胞免疫功能的影响》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、不同麻醉方法及麻醉深度对胃癌手术患者细胞免疫功能的影响【摘要】目的:探讨不同麻醉方法及麻醉深度对胃癌手术患者细胞免疫功能的影响,为临床手术采取合理的麻醉方法提供科学根据。方法：将80例胃癌手术患者随机分成静吸复合麻醉组（A组）和单纯静脉麻醉组（B组），每组40例，组内再各分为深麻醉组（AH组,BH组）和浅麻醉组（AL组,BL组）。深麻醉组和浅麻醉组脑电双频指数（bispectralindex，BIS）分别为35～50和55～68。两组分别于麻醉前、术毕及术后72h检测外周血T淋巴细胞亚群及NK细胞数量。结果:术毕各组CD3+、CD4+、CD4+/CD8
2、+及NK细胞数量均较麻醉前下降（P<0.05）,同种麻醉方法AL组、BL组较AH组、BH组下降明显（P<0.05）；术后72h各组各项指标均恢复至麻醉前水平；在相同时段不同麻醉方法深、浅麻醉组之间各指标差异无统计学意义（P>0.05）。结论：静吸复合麻醉与单纯静脉麻醉均可影响患者的细胞免疫功能，但深麻醉状态较浅麻醉状态影响小，可能与患者应激反应有关。【关键词】麻醉，全身·麻醉，吸入·麻醉，静脉内·胃肿瘤·T淋巴细胞·杀伤细胞，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 恶性肿瘤患者机体多存在免疫功能异常
8、，外科手术导致的应激反应会引起机体免疫功能的下降，从而提高术中细胞微栓的存活率，有利于肿瘤细胞
