The Effects Of Different Doses Of Dexmedetomidine On Inflammatory Factors And T Lymphocyte Immune Function During Laparoscopic Surgery In Patients With Gynecological Malignant Tumors

Objective:To explore the effects of different doses of dexmedetomidine（DEX）on inflammatory factors and T lymphocyte immune function in patients with gynecological malignant tumors undergoing laparoscopic surgery.Methods:A total of 60 patients with gynecological malignant tumors who were scheduled to undergo laparoscopic surgery from January 2021 to December 2021 in the Second Hospital of Shanxi Medical University were selected,including 36 cases of cervical cancer（Ⅰ～ⅡA stage）,17 cases of endometrial carcinoma（Ⅰstage）,7 cases of ovarian cancer（ⅠA～ⅢC stage）.They were divided into control group（group C）,low-dose DEX group（D_lgroup）and high-dose DEX group（D₂group）by using random number table method.Patients in D₁and D₂groups were pumped DEX 0.5ug/kg and 1.0ug/kg 10minutes before induction of anesthesia,then maintained at DEX 0.05ug/（kg·h）and1.0ug/（kg·h）until 30 minutes before operation,and patients in group C were given the same amount of physiological saline.The 10 milliliters peripheral venous blood were collected at 10 minutes before induction of anesthesia（T₁）,1 hour after pneumoperitoneum（T₂）and 24 hours after pneumoperitoneum（T₃）.The level of Interleukin-6（IL-6）,Interleukin-10（IL-10）,CD4⁺,CD8⁺,CD4⁺/CD8⁺of the three groups were compared,and the cases of bradycardia and hypotension in perioperative period and the time of first exhaust after operation were recorded.Results:In group C,the levels of IL-6,IL-10 and CD8⁺at T₂and T₃were higher than those at T₁（all P<0.05）;In group C,the levels of CD4⁺and CD4⁺/CD8⁺at T₂and T₃were lower than those at T₁（all P<0.05）.At T₂and T₃,the expression levels of IL-6 in Group D₁and D₂were lower than those in Group C,and the differences were statistically significant（all P<0.05）.At T₂,the expression level of IL-10 in Group D₁was not significantly different from Group C（P>0.05）,while that in Group D₂was lower than that in Group C and the difference was statistically significant（P<0.05）.At T₃,the expression levels of IL-10 in Group D₁and D₂were both lower than those in Group C,and the differences were statistically significant（all P<0.05）.At T₂,the expression level of CD4⁺in Group D₂was higher than that in Group C,and the difference was statistically significant（P<0.05）.At T₃,the expression levels of CD4⁺in Group D₁and D₂were both higher than those in Group C,and the differences were statistically significant（all P<0.05）.At T₂,the expression level of CD8⁺in Group D₂was lower than that in Group C,and the difference was statistically significant（P<0.05）.At T₃,the expression levels of CD8⁺in Group D₁and D₂were both lower than those in Group C,and the differences were statistically significant（all P<0.05）.At T₂and T₃,the expression levels of CD4⁺/CD8⁺in Group D₁and D₂were both higher than those in Group C,and the differences were statistically significant（all P<0.05）.Conclusion:Dexmedetomidine can inhibit the inflammatory reaction during laparoscopic surgery in patients with gynecological malignant tumors,reduce the damage of immune function,promote the recovery of immune function,and accelerate postoperative recovery.And the effect of high dose of DEX is more significant than low dose.But high dose of DEX is more likely to cause hemodynamic fluctuations in perioperative period.