唐琦

【摘 要】目的：在乳腺癌根治术患者术中应用右美托咪定维持麻醉，并分析其对麻醉效果以及T淋巴细胞亚群水平的影响。方法：选取2019年7月至2021年7月，在我院接受乳腺癌根治术治疗的48例乳腺癌患者。采取随机数字表法，将其分为两组。对照组24例，应用常规全身麻醉；观察组24例，在全身麻醉基础上术中应用右美托咪定维持麻醉。对比两组患者的麻醉效果以及T淋巴细胞亚群水平。结果：两组患者清醒时间无明显差异（P>0.05）；观察组患者术后 6h静息状态VAS评分明显低于对照组，术后1d睡眠评分更低，差异明显（P<0.05）；术后24h，观察组患者CD3+、CD4+、CD4+/CD8+水平均高于对照组，CD8+水平低于对照组（P<0.05）。结论：术中应用右美托咪定维持麻醉不会延长患者麻醉清醒时间，且能够提高术后镇痛效果，改善患者睡眠质量及提高T淋巴细胞亚群水平，值得推广。

【关键词】乳腺癌根治术；右美托咪定；T淋巴细胞亚群；麻醉效果

Effects of dexmedetomidine on anesthesia and T lymphocyte subsets in patients undergoing radical mastectomy for breast cancer

TANG Qi

Wujin Hospital of Traditional Chinese Medicine， Changzhou， Jiangsu 213161， China

【Abstract】Objective： To maintain anesthesia with dexmedetomidine during radical mastectomy for breast cancer， and to analyze the effect of dexmedetomidine on anesthesia effect and T lymphocyte subgroup level. Methods： From July 2019 to July 2021， 48 patients with breast cancer who received radical mastectomy in our hospital were selected. They were divided into two groups by random number table method.The control group （n = 24） received conventional general anesthesia；The observation group 24 patients were treated with dexmedetomidine on the basis of general anesthesia. The anesthesia effect and T lymphocyte subgroup level were compared between the two groups. Results： There was no significant difference in awake time between the two groups（P>0.05）； The VAS score of the observation group was significantly lower than that of the control group 6hours after surgery， and the sleep score was lower 1day after surgery， with significant difference（P<0.05）；24 hours after operation， the levels of CD3+， CD4+ and CD4+ /CD8+ in the observation group were higher than those in the control group， while the level of CD 8+ was lower than that in the control group（P<0.05）.Conclusion： The use of dexmedetomidine to maintain anesthesia during operation does not prolong the awake time of anesthesia， and can improve postoperative analgesia effect， sleep quality and T lymphocyte subgroup level of patients， which is worthy of promotion.

【Key？Words】Radical mastectomy for breast cancer； Dexmedetomidine； T lymphocyte subsets； Anesthesia effect

乳腺癌是女性常見恶性肿瘤，近年来，随着生活压力的增加，乳腺癌发病率也呈现出上升趋势。乳腺癌根治术是乳腺癌治疗的主要术式，研究发现，患者术后感染风险较高，主要是由于患者机体免疫力较差，而麻醉是影响机体免疫的重要原因。因此，在选择麻醉方案时，应在确保麻醉效果的同时尽量保护患者免疫功能。右美托咪定是一种新型α2肾上腺能受体激动剂，具有良好的镇痛、镇静、改善睡眠、抗交感等作用，同时可抑制神经炎症反应，促进机体免疫的恢复[1]。因此，本文将在乳腺癌根治术患者术中应用右美托咪定维持麻醉，并分析其对麻醉效果以及T淋巴细胞亚群水平的影响，现报道如下。……