摘要
目的评价不同镇痛方法对盆腔手术患者血浆中细胞因子变化的影响,并与传统术后镇痛法进行比较,探讨术后充分镇痛对免疫功能的影响。方法根据镇痛方法不同,将60例行子宫切除患者随机分为3组:第Ⅰ组患者为术后根据临床需要,临时给予哌替啶50mg肌肉注射(Ⅰ组,n=20);第Ⅱ组患者为罗哌卡因复合芬太尼硬膜外镇痛组(Ⅱ组,n=20);第Ⅲ组患者为芬太尼静脉镇痛组(Ⅲ组,n=20);观察麻醉前30min、手术后30min、2h、24h、48h和72h六个时点患者血清中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)水平的变化。结果3组患者术后血清IL-6、IL-8、IL-10水平与麻醉前值比较均升高(P<0.01),一般在术后24h达峰值。比较血清IL-6、IL-8、IL-10浓度变化,Ⅱ和Ⅲ组抑制这3种细胞因子释放的能力明显强于Ⅰ组(P<0.05),与Ⅲ组比较,Ⅱ组更为明显(P<0.05)。结论硬膜外局麻药复合阿片受体激动药镇痛模式可更有效地降低术后炎性应激反应。
Objective To compare the effect of different analgesic techniques on the levels of serum cytokines after hysterectomy. Methods Sixty patients were randomly divided into three groups. Group Ⅰ received 50 mg pethidine when needed,Group Ⅱ received ropivacaine ＋ fentanyl for PCEA,group Ⅲ received fentanyl for PCIA. The levels of serum interleukin-6, interleukin-8 and interleukin-10 were observed at six time points ： before anesthesia, at 0. 5 ,2,24,48 and 72 h after the end of surgery. Results The levels of serum IL-6,IL-8 and IL-10 increased significantly after operation, reached at peak values at 24 h （ P 〈 0.05 ） , and then gradually declined but still higher than the baseline values. The serum IL-6 and IL-10 were significantly lower at 2 and 24 h in group Ⅱ and Ⅲ than those in group Ⅰ （ P 〈0.05） . Compared with group Ⅲ, the serum IL-10 was significantly lower at 24 h in group Ⅱ （ P 〈 0.05 ）. Conclusion Epidural analgesia can reduce the level of serum interleukin-6,interleukin-8 and interleukin-10 and inflammatory response after hysterectomy more efficient than PCIA.
出处
《中国微生态学杂志》
CAS
CSCD
2008年第1期71-72,74,共3页
Chinese Journal of Microecology
