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目的:探究地佐辛在妇科恶性肿瘤术后镇痛中的疗效及对其围手术期免疫功能的影响,为临床手术用药提供依据。方法:选择2012年7月~2015年9月期间我院行妇科恶性肿瘤手术患者87例为研究对象,采用随机数字法将其分为地佐辛组(45例)和对照组(42例),地佐辛组患者给予全身麻醉联合地佐辛治疗,对照组患者给予全身麻醉联合芬太尼治疗,记录并分析两组患者术中、术后VAS疼痛评分、Ramsay镇静评分及免疫指标。结果:两组患者术后各时间点的VAS评分均分均小于4分,地佐辛组患者在T3时刻VAS评分显著低于对照组(P<0.05);与T1时刻比较,T2、T4时刻地佐辛组患者CD3~+、CD4~+、CD4~+/CD8~+及NK细胞水平均显著降低(P<0.05),T2时刻地佐辛组患者CD8~+水平显著升高(P<0.05);对照组T2时刻CD3~+、CD4~+、CD4~+/CD8~+及NK细胞水平,T4时刻CD3~+、NK细胞水平,T5时刻NK细胞水平均出现明显降低(P<0.05);地佐辛组患者T5时刻CD3~+、CD4~+、CD4~+/CD8~+及NK细胞水平均显著高于对照组(P<0.05)。结论:地佐辛治疗妇科肿瘤患者术后镇痛效果较好、安全性高,与芬太尼比较,其对机体的免疫抑制作用轻,更利于患者疾病的控制与康复,值得在临床应用推广。
Objective: To investigate the effect of dezocine in the postoperative analgesia of gynecologic malignancies and its influence on perioperative immune function, and provide the basis for the clinical operation. Methods: From July 2012 to September 2015, 87 patients with gynecological malignant tumor undergoing surgery in our hospital from July 2012 to September 2015 were selected and divided into dezocine group (n = 45) and control group (n = 42) by random number method. The patients in dezocine group were given general anesthesia combined with dezocine. The patients in control group were given general anesthesia and fentanyl. The intraoperative and postoperative VAS pain score, Ramsay sedation score and immune index were recorded and analyzed. Results: VAS scores of both groups were less than 4 points at all time points after operation, VAS score of patients in dezocine group at T3 was significantly lower than that of control group (P <0.05). Compared with T1, T2 and T4 The levels of CD3 +, CD4 +, CD4 + / CD8 + and NK cells in the dezocine group were significantly decreased (P <0.05), and the levels of CD8 + + in the dezocine group were significantly increased at T2 (P < 0.05). CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + and NK cells in control group at T2 were significantly lower than those in control group ). The levels of CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + and NK cells at T5 in dezocine group were significantly higher than those in control group (P <0.05). Conclusion: Dezocine in patients with gynecologic oncology has better postoperative analgesic effect and higher safety. Compared with fentanyl, dezocine has less immunosuppressive effect on the body and more conducive to the control and rehabilitation of patients’ diseases, which is worthy of promotion in clinical application .