Effect Of Propofol Combined With Remifentanil Intravenous Anesthesia On Lymphocyte Subsets In Patients Undergoing Laparoscopic Radical Gastrectomy

Objective: In this study,propofol remifentanil intravenous anesthesia underwent radical laparoscopic radical gastrectomy patients perioperative changes in peripheral blood lymphocyte subsets in order to explore the propofol remifentanil anesthesia in patients with gastric cancer Impact of immune function during surgery.Methods: According to the approval of the Second Affiliated Hospital of Dalian Medical University Ethics Committee,34 patients who underwent preoperative laparoscopic radical gastrectomy for gastric cancer from May 2017 to January 2018 were enrolled in this study.ASA was classified as grade I ~ II,The standard anesthesia induction and maintenance.The rats were sacrificed at the beginning of the induction of anesthesia(T1),5 minutes after the induction of anesthesia(T2),immediately after the start of the operation(T3),all the anesthetics were stopped at the end of the operation(T4),3 days after the operation(T5),5 days after the operation(T6),7 days after operation(T7).The total number of lymphocytes,the total number of T lymphocytes,the number of CD8 + lymphocytes,CD4 + lymphocytes and NK cells in peripheral blood were measured by flow cytometry / CD8 ratio.Results: The number of lymphocyte subsets in peripheral blood of patients was significantly higher than that before induction of anesthesia(T1),after induction of anesthesia(T2),the beginning of surgery(T3),the end of surgery(T4),the 3 days after surgery(T5),5 days after surgery(T6),the total number of lymphocytes 7 days after operation(T7),Lymphocytes,CD8 + lymphocytes,CD4 + lymphocytes and NK cellsdecreased to some extent(P <0.05).The total number of lymphocytes,total T lymphocytes and CD8 + lymphocytes continued to decline with the prolongation of anesthesia time,At the end of surgery,the volume of CD4 + lymphocytes increased slightly after 3 days,and then rebounded.CD4 + lymphocytes began to decline with the start of anesthesia and then dropped to the lowest level 3 days after the operation,then rose;NK cells decreased after induction of anesthesia,The lowest after surgery,a slight rebound after surgery,a slight decline after 3 days,and then rebounded;all of the above lymphocytes did not recover to the preoperative level within 7 days after the operation;CD4 + / CD8 + increased after induction and reached the peak immediately after the operation,Reduce,also maintained at a high level after surgery.Conclusion: Intravenous anesthesia with propofol combined with remifentanil can reduce the number of peripheral blood lymphocytes in patients with gastric cancer after induction of general anesthesia.T cells and NK cells decreased significantly after induction of anesthesia and maintained at a low level during operation.With time prolonged recovery,but failed to return to preoperative levels within 7 days after surgery,indicating that propofol combined remifentanil intravenous anesthesia in patients with laparoscopic radical gastrectomy suppression of perioperative immune function.