【摘要】：目的探討磷酸肌酸鈉預(yù)處理對(duì)老年胃癌手術(shù)患者循環(huán)功能及術(shù)后早期疲勞狀態(tài)、機(jī)體免疫功能的影響。方法將80例行胃癌根治術(shù)老年患者隨機(jī)分為觀察組和對(duì)照組各40例,均給予相同的麻醉誘導(dǎo)、麻醉維持及手術(shù)方法。觀察組在麻醉誘導(dǎo)前給予磷酸肌酸鈉2 g加入0.9%氯化鈉注射液100 m L中靜滴,術(shù)后第1~3天繼續(xù)滴注;對(duì)照組給予等容積0.9%氯化鈉注射液靜滴。對(duì)比分析兩組麻醉誘導(dǎo)前(T0)、氣管插管即刻(T_1)、氣管插管后5 min(T_2)、開(kāi)腹即刻(T_3)、開(kāi)腹后5 min(T_4)患者心排血量(CO)、每搏輸出量(SV)以及左心室舒張末期容積(LVEDV),術(shù)后第1、2、3天疲勞指數(shù),術(shù)前及術(shù)后第1、3天T淋巴細(xì)胞亞群及免疫球蛋白。結(jié)果兩組T_1、T_2、T_3、T_4時(shí)CO、SV均較T0時(shí)降低,LVEDV升高,且T_2、T_4時(shí)變化最明顯(P均0.05或0.01);而對(duì)照組T_2、T_4時(shí)CO、SV低于觀察組,T_4時(shí)LVEDV高于觀察組(P均0.01)。兩組術(shù)后第1、2、3天疲勞指數(shù)評(píng)分均高于術(shù)前(P均0.01),并呈現(xiàn)先升高后降低趨勢(shì),術(shù)后第2、3天觀察組疲勞指數(shù)評(píng)分低于對(duì)照組(P0.05或0.01)。術(shù)后第1天兩組CD3~+、CD4~+T淋巴細(xì)胞水平及CD4~+/CD8~+均較術(shù)前降低,且對(duì)照組CD4~+T淋巴細(xì)胞水平及CD4~+/CD8~+低于觀察組(P均0.01);術(shù)后第3天兩組CD3~+、CD4~+T淋巴細(xì)胞水平及CD4~+/CD8~+均較術(shù)后第1天升高,且觀察組CD4~+T淋巴細(xì)胞水平及CD4~+/CD8~+高于對(duì)照組,CD8~+T淋巴細(xì)胞水平低于對(duì)照組(P均0.05或0.01)。術(shù)后第1、3天兩組血清Ig A、Ig G、Ig M水平均較術(shù)前降低(P均0.01),且觀察組各指標(biāo)略高于對(duì)照組(P均0.05),但術(shù)后第3天觀察組Ig A水平高于對(duì)照組(P0.05)。結(jié)論磷酸肌酸鈉預(yù)處理能改善老年胃癌患者術(shù)中循環(huán)功能,同時(shí)能在一定程度上減輕患者術(shù)后早期疲勞程度及免疫抑制狀態(tài),從而促進(jìn)其早期恢復(fù)。
[Abstract]:Objective to investigate the effects of creatine phosphate preconditioning on circulatory function, early postoperative fatigue and immune function in elderly patients with gastric cancer. Methods 80 elderly patients undergoing radical gastrectomy were randomly divided into the observation group (n = 40) and the control group (n = 40). All patients were given the same anesthesia induction, anesthesia maintenance and operation methods. Before anesthesia induction, the observation group received intravenous drip of creatine phosphate sodium phosphate (2g) and 0.9% sodium chloride injection (100ml), and the control group received 0.9% sodium chloride injection (0.9% sodium chloride) intravenously on the 1st day after operation. (CO), of cardiac output was compared between two groups before anesthesia induction (T0), immediately after tracheal intubation (TCI), 5 min after endotracheal intubation (T _ 2), immediately after operation (T _ 3), 5 min after operation (T _ 4). The fatigue index of left ventricular end-diastolic volume (LVEDV),) and left ventricular end-diastolic volume (LVEDV),) was 3 days after operation, and the T lymphocyte subsets and immunoglobulins before and 1 day after operation. Results in both groups, CO,SV decreased and LVEDV increased at T _ 1 / T _ 2T _ 3 / T _ S _ 4 and T _ (2) / T _ (4) (all P < 0. 05 or 0. 01). However, the CO,SV of the control group at T _ 2 and T _ 4 was lower than that of the observation group, and the LVEDV at T _ (4) was higher than that in the observation group (P < 0.01). The scores of fatigue index on the 1st and 2nd day after operation in both groups were higher than those before operation (P 0.01), and the fatigue index scores in the observation group were lower than those in the control group on the 2nd day after operation (P0.05 or 0.01). On the first day after operation, the levels of CD3~, CD4~ T lymphocytes and CD4~ / CD8~ in the two groups were lower than those before operation, and the levels of CD4~ T lymphocytes and CD4~ / CD8~ in the control group were lower than those in the observation group (P0.01). On the 3rd day after operation, the levels of CD3~, CD4~ T lymphocytes and CD4~ / CD8~ in the two groups were higher than those in the control group, and the levels of CD4~ T lymphocytes and CD4~ / CD8~ in the observation group were higher than those in the control group. The level of CD8~ T lymphocyte was lower than that of control group (P 0. 05 or 0. 01). On the 1st day after operation, the serum levels of Ig G M in the two groups were lower than those before operation (P 0.01), and the indexes in the observation group were slightly higher than those in the control group (P 0.05). But on the third day after operation, the Ig A level in the observation group was higher than that in the control group (P 0.05). Conclusion the pretreatment with creatine phosphate can improve the circulatory function of the aged patients with gastric cancer during operation, at the same time, it can alleviate the early fatigue and immunosuppressive state of the patients, and promote the early recovery of gastric cancer.
【作者單位】： 南京醫(yī)科大學(xué)附屬無(wú)錫市第二人民醫(yī)院;南京醫(yī)科大學(xué)附屬無(wú)錫市人民醫(yī)院;
【分類號(hào)】：R735.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前7條

1 葉柏波;劉德昭;沈?qū)?;磷酸肌酸鈉對(duì)腹腔鏡前列腺癌根治術(shù)患者心肌損傷的影響[J];中華臨床醫(yī)師雜志(電子版);2011年13期

2 朱靖;姚紅梅;;磷酸肌酸鈉改善惡性腫瘤化療患者生活質(zhì)量的效果觀察[J];海南醫(yī)學(xué);2012年16期

3 林文輝;林雪華;謝彬;;注射用磷酸肌酸鈉對(duì)阿霉素心臟毒性的保護(hù)作用[J];腫瘤基礎(chǔ)與臨床;2010年01期

4 許夕霞;檀碧波;魏敬妙;王敏;王玲玲;李勇;;磷酸肌酸鈉治療胃癌手術(shù)后疲勞綜合征的效果觀察[J];天津醫(yī)藥;2014年08期

5 許夕霞;檀碧波;宿桂霞;周燁;王彥霞;李勇河;;磷酸肌酸鈉對(duì)胃癌術(shù)后疲勞綜合征患者免疫功能的影響[J];中國(guó)中西醫(yī)結(jié)合外科雜志;2014年02期

6 王瑛;張艷秋;張良玉;官鳳云;;注射用磷酸肌酸鈉在應(yīng)用表阿霉素化療中心臟毒性保護(hù)作用[J];黑龍江醫(yī)學(xué);2011年10期

7 魏素菊;劉凝華;韓文峰;;磷酸肌酸鈉對(duì)小鼠移植性S180肉瘤生長(zhǎng)的影響[J];陜西醫(yī)學(xué)雜志;2010年03期

相關(guān)會(huì)議論文 前1條

1 魏素菊;劉凝華;韓文峰;張凱;史英;;注射用磷酸肌酸鈉對(duì)小鼠S_(180)肉瘤生長(zhǎng)的影響[A];第五屆全國(guó)中醫(yī)藥免疫學(xué)術(shù)研討會(huì)——暨環(huán)境·免疫與腫瘤防治綜合交叉會(huì)議論文匯編[C];2009年

相關(guān)碩士學(xué)位論文 前3條

1 史英;磷酸肌酸鈉對(duì)人卵巢癌細(xì)胞SKOV3的體外作用及其機(jī)制研究[D];河北醫(yī)科大學(xué);2009年

2 吳振;右美托咪定復(fù)合磷酸肌酸鈉對(duì)老年人食管癌根治術(shù)術(shù)后譫妄的影響[D];河北醫(yī)科大學(xué);2013年

3 劉凝華;磷酸肌酸鈉對(duì)小鼠移植性S_（180）肉瘤生長(zhǎng)的影響及其機(jī)制的研究[D];河北醫(yī)科大學(xué);2009年

，

本文編號(hào)：2299367