不同麻醉方法对宫颈癌手术患者免疫功能的影响

摘要

Objective To study the effect of different anesthetic methods on immune function of patients after cervical cancer surgery.Methods 60 patients with cervical cancer were randomly divided into the epidural anesthesia group and general anesthesia group,30 cases in each.2 h before and after anesthesia,and 1,3,5,7 d after surgery,peripheral blood was collected. The number of Tlymphocyte subsets ( CD3+,CD4+,CD8+,CD4+/CD8+) and natural killer cells ( NK cells) were detected by flow cytometry.Results Compared with before anesthesia,the number of CD3+,CD4+,CD8+,CD4+/CD8+and NK cells decreased 2 h after anesthesia;1 d after surgery,each index decreased significantly.3 d after surgery,each index recovered, but still below the level before anesthesia;5 d after surgery,each index of epidural anesthesia group recovered to the before the an-esthesia,general anesthesia group recovered 7 d after surgery.Conclusion Epidural anesthesia has less effect on the immune function of patients with cervical cancer than general anesthesia.%目的：探讨不同麻醉方法对宫颈癌手术患者免疫功能的影响。方法将60例宫颈癌患者随机分为硬膜外麻醉组和全身麻醉组2组，每组30例。分别于麻醉前、后2 h及术后第1、3、5、7天采集外周血，用流式细胞仪检测T淋巴细胞亚群（ CD3＋、CD4＋、CD8＋、CD4＋／CD8＋）以及自然杀伤细胞（ NK细胞）的数量变化情况。结果与麻醉前相比，麻醉后2 h 2组患者CD3＋、CD4＋、CD8＋、CD4＋／CD8＋及NK细胞的数量均有所下降；术后第1天各指标下降显著。术后第3天有所恢复，但仍低于麻醉前水平；术后第5天硬膜外麻醉组各项指标恢复到麻醉前水平，全身麻醉组需要在术后第7天恢复。结论硬膜外麻醉对宫颈癌患者的免疫功能影响较小。