摘要
【目的】探讨术前输注氟比洛芬酯（凯纷）对子宫切除术患者围术期血浆皮质醇（Cor）、白介素10（IL-10）、肿瘤坏死因子α（TNF-α）的影响和意义。【方法】择期行子宫切除术患者60例，ASAⅠ～Ⅱ级，随机分两组，凯纷组和芬太尼组，每组30例。凯纷组在手术切皮前5min静脉输注凯纷1mg／kg，芬太尼组在手术切皮前5min静脉榆注芬太尼1μg／kg，术毕两组静脉自控镇痛（PCIA），镇痛液组方按芬太尼20μg／kg加生理盐水配成100mL，以2mL／h恒速泵注，自控给药剂量0．5mL／次，锁定时间15min，视觉模拟评分法（VAS）行术后12、24及48h静止和活动评分，分别在开放静脉前（T1）、手术结束时（T2）、术后24h（T3）、术后48h（T4）采取外周静脉血4mL测定血浆Cor、IL-10、TNF-α浓度。【结果】两组患者在各时间点的BP、HR、RR、Sp02值差异无显著性（P〉0．05）两组患者在术后12h（T2）和术后24h（T3）活动时视觉模拟评分（VAS值）比较差异具有显著性，凯纷组低于芬太尼（P〈0．05）；两组患者的血浆Cor、IL-10、TNF-α在T2显著升高，与T1比较差异具有显著性（P〈0．05）；两组患者的血浆Cor在T2、T3时，凯纷组明显低于芬太尼，差异具有显著性（P〈0．05），而血浆IL-10在T2、T3和T4凯纷组明显高于芬太尼组，差异具有显著性（P〈0．05）；TNF-α在T2、T3和T4，凯纷组明显低于芬太尼组，差异具有显著性（P〈0．05）。【结论】术前输注凯纷能缓解子宫切除术患者术后疼痛应激反应和改善机体的免疫功能。
[Objective]To evaluate the effect of flurbiprofen axetil by intravenous injection before hysterectomy on expression of cortisol（Cor）, interleukin 10（IL-10） and tumor necrosis factor-alpha（TNF-α） during perioperative period, and to explore its significance. [Methods] Sixty selective hysterectomy patients were randomly divided into 2 groups with 30 cases for each. Flurbiprofen axetil group received intravenous injection of lipid microspheres flurbiprofen axetil lmg/Kg at 5 minutes before surgical incision. Fentanyl group received intravenous injection of fentanyl 1μg/kg at 5 minutes before surgical incision. Both groups received fentanyl 20/Lg/（kg·100mL） with patient-contolled intravenous analgesia（PCIA） （bolus 0.5 ml,lock time 15min,back ground infusion 2 mL/h）. Pain was assessed by visual analog scaies（VAS） at 12,24,48h after surgery. Peripheral venous blood samples were respectively taken before anesthesia（T1 ）, at the end of operation （T2）, at the 24th hour（T3 ） and the 48th hour（T4） after operation, and plasma level of Cor, IL-10 and TNF-α was detected. [Results]The VAS of activity in flurbiprofen axetil group at T2 and T3 was significantly lower than that in fentanyl group, and there was significant difference between two groups（ P〈0.05）. The levels of Cor, IL-10 and TNF-α in two groups increased the most high at Tz, and there was significant difference between at T1 and T2 （ P〈0.05）. The level of Cor in flurbiprofen axetil group at T2 and T3 was significantly lower than that in fentanyl group, and there was significant difference between two groups（ P〈0.05）. The level of IL-10 in flurbiprofen axetil group at T2, T3 and T4 was significantly higher than that in fentanyl group, and there was significant difference between two groups（ P〈0.05）. The level of TNF-αin flurbiprofen axetil group at T2, T3 and T4 was signifi- cantly lower than that in fentanyl group, and there was significant difference between two groups（ P〈0.05）. [Conclusion] Lipid microspheres Flurbiprofen axetit by intravenous injection before hysterectomy can relieve patients postoperative, pain stress reaction and improve their immunologic function.
出处
《医学临床研究》
CAS
2009年第6期954-957,共4页
Journal of Clinical Research
基金
常德市科技局社会发展基金资助项目（科目编号20604,项目编号2008sk02）
