Effect of dexmedetomidine on inflammatory factors and immune function in elderly patients undergoing laparoscopic radical resection of colorectal cancer

摘要

Objective: To investigate the effect of dexmedetomidine on inflammatory factors and immunefunction in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods: From April 2016 to April 2017, 86 cases of elderly laparoscopic radical resectionof colorectal cancer in our hospital were selected and randomly divided into the observationgroup and the control group. 2 groups of patients were open venous access, oxygen mask,monitoring heart rate (HR), blood pressure (BP), electrocardiogram (ECG), oxygen saturation(SpO2), bispectral index (BIS), after induction of anesthesia, the observation group wasgiven dexmedetomidine 0.4 g/kg to 20 mL of normal saline control. Group of 20 mL saline,15 min infusion is completed, and the observation group of dexmedetomidine in 0.4 g/kg- h continuous infusion of normal saline control group, continuous infusion, until the endof surgery. Before induction of anesthesia (T0), 2 h after operation beginning (T1), at theend of operation (T2), 24 h after operation (T3) in venous blood, using ELISA method forthe determination of serum interleukin-2 receptor (sIL-2R) and interleukin-6 (IL-6), tumornecrosis factor alpha (the level of TNF-alpha); on preoperative and postoperative 4 h, 12 h,24 h after operation in venous blood serum epinephrine ELISA method (E), norepinephrine(NE), endothelin-1 (ET-1) level; on preoperative and postoperative 4 h, 12 h after surgery,24 h venous blood flow cytometry determination of CD3+, CD4+, CD8+, CD4+/CD8+. Results:compared with before operation, the observation group after 4 h, 12 h, 24 h NE, and the lowercontrol group E, NE and ET-1 increased, the observation group after 4 h, 12 h, 24 h E, NE,ET-1 lower than that of the control group; compared with T0, 2 patients in group T2, T3 sIL-2R,IL-6, TNF-alpha were increased, the observation group T2, T3 sIL-2R, IL-6, TNF- were lowerthan that of the control group; compared with the preoperative, 2 group after 4 h, 12 h, 24 hCD3+, CD4+, CD8+ and CD4+/CD8+ decreased, the observation group after 4 h, 12 h, 24 h CD3+,CD4+, CD8+, CD4+/CD8+ higher than those in the control group. Conclusion: Dexmedetomidinehas a good analgesic effect on elderly patients undergoing laparoscopic radical resection ofcolorectal cancer. It can effectively relieve the stress reaction and inflammatory reaction duringperioperative period, and effectively improve the immune function of the patients.