To investigate the effect of dexmedetomidine on perioperative immune function in patients with hiatal hernia combined with gastroesophageal reflux disease by laparoscopic operation.

A total of 180 patients with hiatal hernia combined with gastroesophageal reflux disease undergoing operation by laparoscopy in our hospital from March 2014 to March 2016 were enrolled in the study.These patients were divided into observation group(90 cases)and control group(90 cases)by random digital table.A loading dose of dexmedetomidine with 0.5 μg/kg was givenat 30 min before induction of anesthesia, and after operation was started, dexmedetomidine was infused at 0.3 μg/(kg·h)until the end of operation in observation group, and the equal loading dose and rateof normal saline was given in control group.The T lymohocyte subpopulations and NK cell levels in plasma were measured by flow cytometry before anesthesia(T1), and after operation(T2), 30 minutes after operation(T3)and 24 hours after operation(T4). The adverse reactions during operation were recorded.

There were no significant differences in the levels of CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ and NK cells between two groups at T1(P>0.05); Compared with T1, the levels of CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ were significantly decreased in both groups at T2, T3 and T4; Compared with control group, the levels of CD3+ , CD4+ , CD4+ /CD8+ and NK cells in peripheral blood were significant higher at T2, T3 and T4(P<0.05). Compared with control group, the incidence of tachycardia and hypertension was decreased and bradycardia, hypotension and wake up delay increased(P<0.05); The incidence of chills and respiratory depression was compared in both groups, the difference was no statistically significant.

Dexmedetomidine assisting anesthesia can significantly improve perioperative immune function in patients undergoing operation by laparoscopy for hiatal hernia combined with gastroesophageal reflux disease, which is worthy of clinical promotion.