国际麻醉学与复苏杂志   2013, Issue (7): 10-10
    
术后镇痛对肿瘤患者围术期免疫功能的影响
陈博, 刘红亮1()
1.重庆市肿瘤研究所
The influence of postoperative analgesia on cancer patients' immune function during perioperative period
 全文:
摘要:

【摘要】 背景:围术期机体免疫系统在清除术后微小残余病灶发挥了重要作用,并减少恶性肿瘤的远期复发与转移。然而,手术及术后疼痛应激能显著抑制机体细胞免疫功能。目前有限的研究数据显示,完善的术后镇痛能缓解围术期细胞免疫功能抑制从而降低远期肿瘤复发转移。但术后镇痛药物及镇痛方法在缓解疼痛的同时,本身会对机体免疫功能产生不同的影响。目的:综述不同镇痛药物及镇痛方法对肿瘤患者围术期免疫功能的影响。内容:简述机体免疫系统的基本概念,围术期免疫抑制的可能机制,阐述不同镇痛药物及镇痛方法对围术期免疫功能和远期预后的影响。趋向:今后仍需要开展大量临床研究来阐明术后镇痛对围术期免疫功能的影响,最终能为恶性肿瘤患者探寻最适合的术后镇痛方案。

关键词: 术后镇痛;肿瘤;围术期;免疫
Abstract:

【Abstract】 Background:The immune system during perioperative period plays an important role in clearing the minimal residual disease,and reduces further tumor growth an metastasis.However,surgery stress and postoperative pain can significantly suppress cell-mediated immunity(CMI).To date,there are limited research data showing that postoperative pain management could relieve suppression of CMI,thus reduce further tumor growth and metastasis.Although,the analgesic agents and analgesic techniques in relieving pain at the same time itself would impact immune function.Obfective: This article reviews the influence of different analgesic agents and analgesic techniques on immune function during perioperative period.Content:This review introduces the concept of immune system and the mechanism of immunosuppression during perioperative period,it also discusses the influence of different analgesic agents and analgesic techniques on immune function and long-term outcome.Trend:A large number of clinical studies are still needed in the future to clarify the influence of postoperative analgesia on immune function,and ultimately to explore the most appropriate postoperative analgesia for patients with malignant tumors.

Key words: Postoperative Analgesia; Tumor; Perioperative Period; Immunity