帕瑞昔布超前镇痛对肿瘤患者围术期免疫功能的影响.docVIP

精品论文 参考文献 帕瑞昔布超前镇痛对肿瘤患者围术期免疫功能的影响 王承海1邵伟1王开岩1朱于临1宋志芳2 　　1烟台市烟台山医院麻醉科山东烟台264008； 　　2烟台市中医医院保健科山东烟台264008 　　【摘要】 　　目的观察帕瑞昔布超前镇痛对消化道肿瘤患者围术期免疫功能的影响。方法 择期行胃癌、结肠癌或直肠癌手术患者60例，随机分为三组：C组和P1组分别于麻醉诱导前30min静脉注射生理盐水2ml和帕瑞昔布40mg；P2组于手术结束前30min静脉注射帕瑞昔布40mg。测定麻醉诱导前（T1）及术后8h（T2）、24h（T3）和48h（T4）时IFNgamma;及IL4的血浆浓度。结果 术后T2、T3及T4时C组和P2组IFNgamma;/IL4比值低于T1时（Plt;005），P1组比值高于C组和P2组（P lt;005），且P2组比值高于C组（Plt;005）。结论帕瑞昔布超前镇痛能缓解消化道肿瘤患者术后Th1/Th2平衡向Th2方向的偏移，对免疫系统有保护作用。 　　【关键词】环氧化物酶；超前镇痛；免疫功能 　　Effect of parecoxib preemptive analgesia to perioperative immune function in tumor patients 　　WANG Chenghai1SHAO Wei1WANG Kaiyan1ZHU Yulin1SONG Zhifang2 　　1Department of Anesthesia，the Hospital of Yantai Shandong Yantai 264008 　　2Yantai city hospital of traditional Chinese medicine health care Shandong Yantai 264008 　　【Abstract】 　　Objective To investigate the effect of parecoxib preemptive analgesia to perioperative immune function in digestive tract tumor patients．Method 60 patients scheduled to undergo elective stomach,colon or rectum tumor surgery were randomized into three groups：Group C and P1 received iv normal saline 2 ml or parecoxib 40mg 30 min before anesthesia induction,and Group P2 received iv parecoxib 40mg 30 min before operation ending．The plasma concentration of IFNgamma; and IL4 was determinated before anesthesia induction (T1）and 8h(T2),24h(T3）and 48h(T4)after the operation．Results At postoperative T2， T3 and T4，IFNgamma; / IL4 ratio of Group C and P2 was lower than that at T1 (Plt;005)，the ratio of Group P1 was higher than that of Group C and P2 (Plt;005),and the ratio of Group P2 was higher than that of Group C (Plt;005)．Conclusion Preemptive analgesia of parecoxib can ease the offset of digestive tract tumor patientsrsquo; postoperative Th1/Th2 balance to Th2 direction，thus has a positive protective effect to immune system． 　　【Key words】Cyclooxygenase；Preemptive analgesia；Immune function 　　【中图分类号】R8175 　　【文献标识码】B【文章编号】16748999(2013)12007001 　　肿瘤患者免疫功能低下，围术期创伤、麻醉及疼痛等