摘要
目的:探讨帕瑞昔布钠术前给药对腹腔镜子宫切除术患者术后应激反应及血清微小RNA(miRNA)miR-150及miR-155表达影响。方法:选取2017年11月-2018年12月本院行子宫切除术患者86例,随机数字表法分为观察组和对照组各43例,对两组常规麻醉后,观察组于术前30min静脉注射帕瑞昔布钠40mg,手术结束前30min按照1.0μg/kg剂量注射枸椽酸芬太尼;对照组手术结束前30min静脉注射观察组相同剂量的帕瑞昔布钠和枸椽酸芬太尼,比较两组术后不同时间点疼痛视觉评分(VAS)和临床疗效;并比较两组术前(T0)、切皮时(T1)及拔管时(T2)血清白细胞介素-6(IL-6)和皮质醇(COR),测定术后不同时间血清miR-150、miR-155水平并分析其与疼痛程度相关性,记录用药期间安全性。结果:手术各时间点DBP、SBP、HR、手术时长、苏醒和拔管时间、出血量两组比较无差异(P>0.05);观察组术中4、8、12、24h疼痛VAS评分均低于对照组,治疗有效率高于对照组(均P<0.05);两组T1、T2时刻COR、IL-6水平均呈上升趋势,但观察组低于对照组(P<0.05);两组术后4、8、12、24h血清miR-150水平上升,血清miR-155水平下降,且观察组变化程度低于对照组(P<0.05);两组疼痛程度均与血清miR-150、miR-155水平呈负相关和正相关(r=-0.852、0.846,P=0.002、0.004);治疗期间两组不良反应发生率无差异(P>0.05)。结论:帕瑞昔布钠术前给药临床效果显著,可明显改善术后患者应激反应,降低血清miR-150和升高血清miR-155表达水平,安全性良好。
Objective:To investigate the effects of preoperative administration of parecoxib sodium on stress response and expression levels of serum microRNA(miRNA)miR-150 and miR-155 of women after laparoscopic hysterectomy.Methods:86 women who wanted laparoscopic hysterectomy were enrolled and were divided into study group and control group(43 cases in each group)by randomized digital table from November 2017 to December 2018.After anesthesia,the women in the study group were given intravenous injection of 40 mg of parecoxib sodium 30 minutes before surgery and were also given fentanyl citrate at a dose of 1.0μg/kg 30 minutes before the end of surgery.The women in the control group were given intravenous injection of 40 mg of parecoxib sodium and fentanyl citrate at a dose of 1.0μg/kg 30 minutes before the end of surgery.The pain visual(VAS)scores at different time point after surgery and the clinical efficacy of women were observed and compared between the two groups.The serum levels of interleukin-6(IL-6)and cortisol(COR)before operation(T0),incision(T1)and at the time of extubation(T2)of women were compared between the two groups.The serum miR-150 and miR-155 levels at different time point of women after surgery were measured,and their correlation with pain degree was analyzed.The safety of women in both groups were recorded.Results:There were no significant different in the values of DBP,SBP and HR,and duration of surgery,recovery and extubation time of women between the two groups(P>0.05).The pain VAS scores of women at 4,8,12,and 24 h of women in the study group were significant lower than those of women in the control group,but the effective rate of women in the study group was significant higher(P<0.05).At the time of T1 and T2,the levels of COR and IL-6 of women in the two groups had increased significantly,but which of women in the study group were significant lower than those of women in the control group(P<0.05).The serum miR-150 level at 4,8,12,and 24 h after surgery of women in the both groups had increased significantly,but the level of serum miR-155 had decreased significantly,and the changes degree of the levels of serum miR-150 and miR-155 of women in the study group were significant less than those of women in the control group(P<0.05).The pain degree of women in the two groups was negatively correlated with the serum miR-150 level(r=-0.852,P=0.002),and was positively correlated with the serum miR-155 level(r=0.846,P=0.004).Conclusion:Parecoxib sodium given before laparoscopic hysterectomy has significant clinical effect,which can significantly alleviate postoperative stress response of women,and can reduce their serum miR-150 level and increase their serum miR-155 level with good safty.
作者
范冬燕
庄新元
FAN Dongyan;ZHUANG Xinyuan(Jiangsu Shengze Hospital(Shengze Branch of Jiangsu People's Hospital),Jiangsu Province,215228)
出处
《中国计划生育学杂志》
2020年第2期198-202,共5页
Chinese Journal of Family Planning
