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目的:对比不同剂量舒芬太尼与地佐辛联用对胃癌术后患者的镇痛效果及对细胞免疫功能的影响。方法:选择择期行胃癌根治术的112患者,根据术后自控静脉镇痛的不同剂量随机分为地佐辛0.5 mg·kg~(-1)组(A组)、地佐辛0.2 mg·kg~(-1)加舒芬太尼1μg·kg~(-1)组(B组)、地佐辛0.3 mg·kg~(-1)加舒芬太尼1.0μg·kg~(-1)组(C组)和地佐辛0.25 mg·kg~(-1)加舒芬太尼1.5μg·kg~(-1)组(D组)4组各28例。比较各组麻醉前(T1)及术后1 h(T2)、24 h(T3)、48 h(T4)的VAS疼痛评分及细胞免疫功能指标的变化。结果:T2~T4时A、B组的VAS疼痛评分均显著高于C、D组(P<0.05),D组术后恶心、呕吐发生率显著高于其他3组(P<0.05)。A、C组在T4时的CD3~+、CD4~+、CD4~+/CD8~+及NK细胞水平显著高于T1时及B、D两组(P<0.05)。结论:地佐辛0.3 mg·kg~(-1)加舒芬太尼1.0 ug·kg~(-1)的自控静脉镇痛方案对胃癌术后患者不仅镇痛效果良好,而且有利于术后细胞免疫功能的恢复。
OBJECTIVE: To compare the analgesic effect of sufentanil with dezocine in patients with postoperative gastric cancer and their effects on cellular immune function. Methods: One hundred and twelve patients undergoing radical gastrectomy were randomly divided into two groups according to the postoperative controlled intravenous analgesia: dezocine 0.5 mg · kg -1 (group A), dezocine 0.2 mg · kg (-1) plus sufentanil 1 μg · kg -1 (group B), dezocine 0.3 mg · kg -1 plus sufentanil 1.0 μg · kg -1 Group C (group C) and dezocine 0.25 mg · kg -1 and sufentanil 1.5 μg · kg -1 (group D). The changes of VAS pain scores and cellular immune function before anesthesia (T1), 1 h (T2), 24 h (T3), 48 h (T4) were compared between groups. Results: The pain scores of VAS in group A and group B at T2 ~ T4 were significantly higher than those in group C and D (P <0.05). The incidence of postoperative nausea and vomiting in group D was significantly higher than that of the other three groups (P <0.05). The levels of CD3 +, CD4 +, CD4 + / CD8 + and NK cells in group A and C at T4 were significantly higher than those at T1 and B and D (P <0.05). Conclusion: The controlled intravenous analgesia with dezocine 0.3 mg · kg -1 and sufentanil 1.0 μg · kg -1 not only has a good analgesic effect for postoperative patients with gastric cancer, but also benefits postoperative Recovery of cellular immune function.