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目的:探讨在食管癌根治术自控镇痛中应用氟比洛芬酯复合舒芬太尼对患者细胞免疫功能的影响。方法:选取2014年2月至2015年3月安阳肿瘤医院60例行食管癌根治术自控镇痛患者随机分为两组,A组为舒芬太尼组,B组氟比洛芬酯复合舒芬太尼组,每组30例。观察术后4 h、12 h、24 h、48 h的镇痛、镇静评分和术前、术后1 d、术后7 d的CD3~+、CD4~+、CD8~+数量及自然杀伤(NK)细胞活性。结果:两组患者不同时间点的疼痛数字评价量表(NRS)评分、Ramsay镇静评分比较,差异均无统计学意义(P>0.05)。与手术前比较,两组患者术后1 d的CD3~+、CD4~+、NK细胞水平均明显降低,NK细胞水平在术后7 d明显降低(P<0.05)。与A组比较,B组术后1 d的CD3~+、CD4~+水平明显升高,NK细胞水平在术后1 d、7 d明显升高(P<0.05)。结论:氟比洛芬酯复合舒芬太尼自控镇痛CD3~+、CD4~+和NK细胞活性轻度下降,复合氟比洛芬酯能够使免疫抑制减轻,在满意镇痛的同时,可获得更大的益处。
Objective: To investigate the effect of flurbiprofen ester and sufentanil on cellular immune function in patients undergoing esophageal cancer radical operation. Methods: From February 2014 to March 2015, 60 patients undergoing esophagectomy and controlled radical analgesia were randomly divided into two groups: group A was sufentanil group, group B was treated with flurbiprofen axetil Fentanyl group, 30 cases in each group. The analgesic and sedation scores at 4 h, 12 h, 24 h and 48 h after operation were observed. The numbers of CD3 +, CD4 +, CD8 + NK) cell activity. Results: There were no significant differences in NRS score and Ramsay sedation scores between two groups at different time points (P> 0.05). Compared with those before surgery, the levels of CD3 +, CD4 +, and NK cells in both groups were significantly decreased 1 d after operation, and the levels of NK cells were significantly decreased at 7 d after operation (P <0.05). Compared with group A, the levels of CD3 + and CD4 + in group B were significantly increased at 1 d after operation, and the levels of NK cells in group B were significantly increased at 1 and 7 d after operation (P <0.05). CONCLUSIONS: Flurbiprofen ester and sufentanil are associated with a slight decrease in CD3 ~ +, CD4 ~ + and NK cell activity. Compound flurbiprofen axetil can reduce immunosuppression. Satisfactory analgesia can be obtained at the same time Get greater benefits.