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1、临床医学全膝关节置换后应用曲马多和吗啡镇痛对T淋巴细胞亚群的影响☆王士雷，焦志华，滕如阳，江岩，王鹏，王世端EffectsofanalgesiawithmorphineortramadolonT-lymphocytesubsetsaftertotalkneereplacementWangShi-lei,JiaoZhi-hua,TengRu-yang,JiangYan,WangPeng,WangShi-duanAbstractAIM:Severepainsmayoccurfollowingtotalkneere
2、placement,andvariousanalgesiadrugsmayhavedifferenteffectsonthepostoperativeimmunefunction.ThisstudyobservedandcomparedtheeffectsofanalgesiawithmorphineandtramadolonT-lymphocytesubsetsaftertotalkneereplacement.METHODS:©Fortypatientsundergoingselectivetotalkn
3、eereplacementwereenrolledfromtheAffiliatedHospitalofQingdaoUniversityMedicalCollegebetweenMayin2006andMayin2007・Theywererandomlydividedintotwogroupsforpatient-controlledintravenousanalgesia(PCIA):morphinegroup(,?=20)andtramadolgroup(??=20).②Inmorphinegroup,
4、theanalgesiaconsistedof0」％morphine+0.01%droperidol.PCIAsetting:loadingdose0.075mL/kg,backgroundinfusion1mL/h.PCIAbolus().5mL,lock-outinterval10minutes,and24-hourlimit5()mL;Intramadolgroup,(heanalgesiaconsistedof1%tramadol+0.01%droperidol.PCIAsetting:loading
5、dose0.15mL/kg,backgroundinfusionImL/h,PCIAbolusImL,lock-outinterval1()minutes,and24-hourlimit70mL・©Beforeanesthesia,andat1,3,5daysaftertotalkneereplacement,thelevelsofT-lymphocytesubsets(CD3[CD4CD8")weredeterminedbymeansofflowcytometry・RESULTS:Allthe40pati
6、entswereinvolvedintheresultanalysis.①Inmorphinegroup,thelevelsofCD3",CD4*andCDS*decreasedsignificantlyat1dayafteroperationcomparedwiththebaselinebeforeoperation(P<0.05),increasedat3days,andrecoveredat5days・②Intramadolgroup・lhelevelsofCD3‘andCD4rdidn'tchange
7、at1dayafteroperationcomparedwiththebaseline,butincreasedat3days(P<0.05),andrecoveredat5days・TherewasnoremarkablechangeofCD8*levelateachtimepointafteroperation.CONCLUSION:Comparedwithmorphine,tramadolcanincreaseCD3"andCD4*levelsobviously,thuspossiblyenhancin
8、gimmunity.Sotramadolissuperiorfortheanalgesiaaftertotalkneereplacement.DepartmentofAnesthesiology,AffiliatedHospitalofQingdaoUniversityMedicalCollege,Qingdao266()03.ShandongProvince.ChinaWangShi-lei☆,D
