利多卡因对颈淋巴结结核切除术患者围术期应激反应和免疫功能影响.docVIP

利多卡因对颈淋巴结结核切除术患者围术期应激反应和免疫功能影响 　　[摘要]目的 ?^察利多卡因对颈淋巴结结核切除术患者围术期应激反应及免疫功能的影响。方法 选取2016年8月～2017年6月在我院择期行颈淋巴结结核切除术患者60例，采用随机数字表法将患者分为利多卡因组（L组）和对照组（C组）。L组气管插管前10 min给予负荷剂量利多卡因1.5 mg/kg，随后以1.5 mg/（kg?h）的速度泵注至术毕；C组持续泵入等容量的生理盐水。记录麻醉诱导前30 min（T0）、手术开始后1 h （T1）、术毕即刻（T2）及术后6 h （T3）的MAP、HR；采用酶联免疫吸附法测定T0～T3时血清去甲肾上腺素（NE）、肾上腺素（E）及皮质醇（Cor）浓度；采用流式细胞仪检测T0～T3时T淋巴细胞亚群（CD3+、CD4+、CD8+、CD4+/CD8+比值）及NK细胞的百分比。结果 T1～T3时两组MAP、HR水平及血清NE、E、Cor浓度明显高于T0时，且C组明显高于L组（P0.05）。T1～T3时，两组的CD3+、CD4+、CD8+和CD4+/CD8+明显低于T0时，且C组明显低于L组（P0.05），T1～T3时，两组的NK细胞水平明显高于T0时，且L组明显高于C组（P0.05）。结论 静脉泵注利多卡因可有效抑制颈淋巴结结核切除术患者围术期应激反应，减少对细胞免疫功能的影响。 　　[关键词]利多卡因；颈淋巴结结核；应激反应；免疫功能 　　[中图分类号] R522 [文献标识码] A [文章编号] 1674-4721（2018）1（c）-0060-04 　　The influence of Lidocaine on the perioperative stress reaction and immunologic function in patients undergoing cervical lymph node tuberculosis resection 　　ZHOU Tian-tian1 CHEN Zi-yang2 YU Shu-xia1 ZHANG Shao-gang1 　　1.Department of Anesthesiology，Affiliated Nanjing Integrated Traditional Chinese and Western Medicine Hospital of Nanjing Traditional Chinese Medicine University，Jiangsu Province，Nanjing 210014，China；2.Department of Anesthesiology，the First Affiliated Hospital of Nanjing Medical University，Jiangsu Province，Nanjing 210029，China 　　[Abstract]Objective To observe the influence of Lidocaine on the perioperative stress response and immunologic function in patients undergoing cervical lymph node tuberculosis resection.Methods Sixty patients scheduled for cervical lymph node tuberculosis resection from August 2016 to June 2017 in our hospital were selected.The patients were divided into Lidocaine group （group L） and control group （group C） according to the random number table method，and there were 30 patients in each group.Group L was administered 1.5 mg/kg bolus dose of Lidocaine before 10 min tracheal intubation，followed by 1.5 mg/（kg?h） infusion until the end of operation while group C was continuously pumped the equal capacity of normal saline.MAP，HR were recorded before 30 mi