多模式镇痛对肺癌患者围术期免疫功能和远期生存影响的研究进展

Research Progress of the Effect of Multimodal Analgesia on the Perioperative Immune Functions and Long-Term Survival for Patients with Lung Cancer

摘要: 目前手术切除仍是早期肺癌的主要治疗方法，但手术、麻醉、疼痛刺激等因素会引发机体一系列应激反应、神经内分泌变化，使患者围术期免疫功能受到影响，从而可能影响肺癌患者的预后。近年来研究表明，围术期多模式镇痛(Multimodal analgesia, MMA)通过联合具有不同镇痛机制的麻醉技术或药物，不仅提供了围术期有效的镇痛，也减少了阿片类药物的使用和副作用，进而可能对患者围术期的免疫有一定的保护作用。但临床麻醉中，多模式镇痛的方式较多，针对具体手术类型，尚未有明确的多模式镇痛方案。本文回顾了肺癌患者围术期多模式镇痛对患者免疫功能和远期生存的影响，以期为临床应用提供参考。

Abstract: At present, surgical resection is still the main treatment for early lung cancer, but surgery, anesthesia, pain stimulation and other factors will lead to a series of stress response and neuroendocrine changes, which will affect the perioperative immune function of patients, which may affect the prognosis of lung cancer patients. In recent years, studies have shown that Multimodalanalgesia (MMA) can not only provide effective perioperative analgesia, but also reduce the use and side effects of opioids by combining with anesthesia technology or drugs with different analgesia mechanisms, which may have a certain protective effect on perioperative immunity of patients. However, in clinical anesthesia, there are many ways of multimodal analgesia, and there is no clear multimodal analgesia plan for specific operation types. This paper reviewed the effects of perioperative multimodal analgesia on the immune function and long-term survival of patients with lung cancer, in order to provide reference for clinical application.