摘要
目的探讨不同麻醉深度对行胃癌手术患者机体免疫细胞的影响,为合理选择麻醉深度提供参考。方法选择2009年5月至2011年8月在我院择期行胃癌手术患者80例,根据患者意愿分为治疗组与对照组各40例,两组都采用常规方法进行全身麻醉,治疗组和对照组维持脑电双频指数(BIS)分别为35～50和58～67。采用流式细胞仪(FCM)检测两组患者麻醉前、手术2 h和术后24 h外周血中T细胞亚群(CD3+、CD4+、CD8+)和NK细胞(CD3-CD16+CD56+)数量。结果两组患者CD3+、CD4+值于手术2 h和术后24 h时显著降低,与麻醉前比较差异有统计学意义(P<0.05);治疗组在手术2 h、术后24 h两个时间点的上述指标值下降没有对照组明显(P<0.05)。各时间点两组CD8+值组内或组间比较差异均无统计学意义(P>0.05)。两组患者NK细胞的数量于手术2 h和术后24 h时显著降低,与麻醉前比较差异有统计学意义(P<0.05);治疗组在手术2 h、术后24 h两个时间点的NK细胞的数量下降没有对照组明显(P<0.05)。结论胃癌手术对患者有一定的应激作用,从而对免疫系统产生损害,而选择比较浅的麻醉深度对T淋巴细胞亚群和NK细胞有一定保护作用,有利于减少免疫功能的损害。
Objective To investigate the effects of different aesthetical depth on the immune cells of patients with gastric cancer in order to provide reference for choosing reasonable aesthetical depth.Methods Totally 80 patients who were underwent elective gastric cancer surgery in our hospital from May 2009 to August 2011 were selected and were equally divided the treatment group and the control group according to their wishes.The conventional anesthesia was applied to all patients.The bispectral index（BIS） was maintained at 35~50 in the treatment group and at 58~67 in the control group.The numbers of T cell subsets（CD3＋,CD4＋,CD8＋） and NK cells（CD3-CD16＋CD56＋） in the peripheral blood before the anesthesia,at 2 hours during the surgery and at 24 hours after the surgery were detected by flow cytometry（FCM）.Results The CD3＋ and CD4＋ values at 2 hours during the surgery and at 24 hours after the surgery in the two groups were significantly reduced compared those before the anesthesia（P0.05）,with more obvious decrease in the control group（P0.05）.The CD8＋ value at each time point was not statistically different between the two groups（P 0.05）.The NK cell numbers at 2 hours during the surgery and at 24 hours after the surgery in the two groups significantly decreased compared to those before the anesthesia（P0.05）,with more obvious decrease in the control group（P0.05）.Conclusion Gastric cancer surgery can exert certain damage on the immune system.Using relatively shallow aesthetical depth can protect T lymphocyte subsets and NK cells and reduce the damage on the immune function.
出处
《局解手术学杂志》
2012年第3期268-270,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
麻醉深度
脑电双频指数
胃癌
免疫细胞
aesthetical depth
bispectral index
gastric cancer
immune cell
