摘要
目的:探讨氟比洛芬酯复合地塞米松在老年卵巢癌根治术中的应用效果。方法:选取2019年5月至2021年6月该院收治的拟行老年卵巢癌根治术的患者97例,采用随机数字表法分为对照组(n=48)和观察组(n=49)。对照组患者使用氟比洛芬酯,观察组患者使用氟比洛芬酯+地塞米松。观察两组患者的认知功能障碍(POCD)发生率、心血管反应和不良反应,比较手术前后血流动力学指标[平均动脉压(MAP)、心率(HR)]水平、视觉模拟评分(VAS)、免疫抑制指标(CD4^(+)、CD3^(+)和CD8^(+))水平、疼痛介质[P物质(SP)、前列腺素E_(2)(PGE_(2))]水平和简易精神状态检查量表(MMSE)评分。结果:(1)术前、术毕和拔管时,两组患者MAP、HR水平比较,差异无统计学意义(P>0.05)。(2)术后6、12 h,观察组患者静息、运动VAS评分明显低于对照组,差异均有统计学意义(P<0.05)。(3)术后12 h,两组患者CD4^(+)、CD3^(+)水平低于术前,CD8^(+)水平高于术前,差异均有统计学意义(P<0.05);术后12、48 h,观察组患者CD4^(+)、CD3^(+)水平高于对照组,CD8^(+)、SP和PGE_(2)水平低于对照组,差异均有统计学意义(P<0.05)。(4)术后12、48 h,观察组患者的MMSE评分高于对照组,差异有统计学意义(P<0.05);术后48 h内,两组患者POCD发生率比较,差异无统计学意义(P>0.05)。(5)观察组患者恶心呕吐发生率低于对照组,差异有统计学意义(P<0.05);两组患者心血管反应发生率比较,差异无统计学意义(P>0.05)。结论:氟比洛芬酯复合地塞米松应用于老年卵巢癌根治术患者,可下调疼痛介质水平,减轻免疫抑制,缓解疼痛,降低恶心呕吐发生率,且对认知功能的影响较小。
OBJECTIVE:To probe into the effect of flurbiprofen axetil combined with dexamethasone in radical resection of ovarian cancer in elderly patients.METHODS:Totally 97 elderly patients undergoing radical resection of ovarian cancer admitted into the hospital from May 2019 to Jun.2021 were selected and divided into control group(n=48)and observation group(n=49)via random number table.The control group was treated with fluorine biprofen axetil,the observation group was given flurbiprofen axetil combined with dexamethasone.The incidences of post-operation cognitive dysfunction(POCD),cardiovascular reactions and adverse drug reactions of the two groups were observed,the hemodynamic indicators[mean arterial pressure(MAP),heart rate(HR)],heart rate(HR),visual analog scale(VAS),immunosuppressive indicators(CD4^(+),CD3^(+) and CD8^(+)),pain mediators[substance P(SP),prostaglandin E_(2)(PGE_(2))]and mini-mental state examination(MMSE)scores were compared between two groups before and after operation.RESULTS:(1)There were no statistically significant differences in MAP and HR levels between two groups before operation,after operation and at the time of extubation(P>0.05).(2)The resting and exercising VAS scores of the observation group were significantly lower than those of the control group at 6 h and 12 h after operation,with statistically significant differences(P<0.05).(3)At 12 h after operation,CD4^(+) and CD3^(+) were lower and CD8^(+) was higher than before surgery in both groups,and the differences were statistically significant(P<0.05).The CD4^(+) and CD3^(+) levels in the observation group were higher than those in the control group at 12 h and 48 h after operation,and the CD8^(+),SP and PGE_(2) levels were lower than those in the control group,with statistically significant differences(P<0.05).(4)The MMSE score of the observation group was higher than that of the control group at 12 h and 48 h after operation,with statistically significant difference(P<0.05);within 48 h after operation,there was no statistically significant difference in the incidence of POCD between two groups(P>0.05).(5)The incidence of nausea and vomiting in the observation group was lower than that in the control group,with statistically significant difference(P<0.05);there was no statistically significant difference in the incidence of cardiovascular reactions between two groups(P>0.05).CONCLUSIONS:Flurbiprofen axetil combined with dexamethasone in elderly patients undergoing radical ovarian cancer surgery can down-regulate pain mediators,reduce immunosuppression,relieve pain,decrease the incidence of nausea and vomiting,which have little effect on cognitive function.
作者
纪玉玮
高艳
JI Yuwei;GAO Yan(Dept.of Anesthesia,Suzhou Municipal Hospital,Jiangsu Suzhou 215000,China)
出处
《中国医院用药评价与分析》
2022年第7期822-825,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
江苏省优势学科建设工程项目(No.YSHL0816-88)。
关键词
卵巢癌根治术
老年
超前镇痛
氟比洛芬酯
地塞米松
心血管反应
免疫抑制
Radical resection of ovarian cancer
Elderly
Preemptive analgesia
Flurbiprofen axetil
Dexamethasone
Cardiovascular reactions
Immunosuppression
