摘要
目的:探讨氟比洛芬酯超前镇痛对腹腔镜子宫切除术患者疼痛介质水平及免疫功能的影响。方法:收集2018年6月-2021年5月本院择期行腹腔镜子宫切除术的患者106例,随机数字表法分为氟比洛芬酯组和对照组各53例,两组均采用气管插管全身麻醉,氟比洛芬酯组于麻醉诱导前将1mg/kg氟比洛芬酯生理盐水稀释至10ml后,1min内静脉泵注完毕;对照组给予等量生理盐水泵注。比较两组麻醉诱导前(T0)、插管时(T1)和拔管时(T2)时平均动脉压(MAP)、心率(HR);拔管后1min(T3)、拔管后5min(T4)和离开麻醉监测治疗室时(T5)的视觉模拟量表(VAS)评分;T0和术后1d血清前列腺素E_(2)(PGE_(2))、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)及T淋巴细胞亚群水平。结果:氟比洛芬酯组T1、T2时MAP、HR均低于对照组,T3、T4、T5时VAS评分均低于对照组;术后1d两组PGE_(2)、TNF-α和IL-6水平均较T0时升高,CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均较T0时降低,但氟比洛芬酯组PGE_(2)、TNF-α和IL-6低于对照组,CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均高于对照组;氟比洛芬酯组咽喉疼痛发生率(13.2%)低于对照组(32.1%)(均P<0.05)。结论:氟比洛芬酯超前镇痛能降低腹腔镜子宫切除术患者术后疼痛介质水平,减轻术后疼痛,减轻患者术后免疫功能抑制,未增加总不良反应。
Objective:To explore the effects of flurbiprofen axetil for preemptive analgesia of patients with laparoscopic hysterectomy on their pain mediators and immunologic function.Methods:A total of 106patients who wanted elective laparoscopic hysterectomy were enrolled between June 2018and May 2021.According to random number table method,these patients were divided into two groups(53cases in each group).The patients in both groups were given general anesthesia under endotracheal intubation.Before anesthesia induction,the patients in the study group were given intravenous pump of 10ml flurbiprofen axetil(dilution with normal saline),while the patients in the control group were given the same volume of normal saline.The values of mean arterial pressure(MAP)and heart rate(HR)before anesthesia induction(T0),at intubation(T1),and extubation(T2),the scores of visual analogue scale(VAS)at 1min after extubation(T3),5min after extubation(T4),and immediately after leaving the post-anesthesia care unit(PACU)(T5),and the levels of serum prostaglandin E_(2)(PGE_(2)),tumor necrosis factor-α(TNF-α),interleukin 6(IL-6),and T lymphocyte subsets at T0and in 1dafter surgery of the patients were compared between the two groups.Results:The values of MAP and HR of the patients in the study group at T1and at T2were significantly lower than those of the patients in the control group,and the VAS scores of the patients in the study group at T3,at T4,and at T5were significantly lower than those of the patients in the control group.1day after surgery,the levels of PGE_(2),TNF-α,and IL-6 of the patients in both groups were significantly higher than those at T0,and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)of the patients in both groups were significantly lower than those at T0.The levels of PGE_(2),TNF-α,and IL-6of the patients in the study group were significantly lower than those of the patients in the control group,and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)of the patients in the study group were significantly higher.The incidence of sore throat(13.2%)of the patients in the study group was significantly lower than that(32.1%)of the patients in the control group(all P<0.05).Conclusion:Flurbiprofen axetil of preemptive analgesia for the patients with laparoscopic hysterectomy can reduce their levels of pain mediators and relieve their postoperative pain and postoperative immunosuppression,without increasing the total adverse reaction.
作者
纪丹丹
朱萍莉
JI Dandan;ZHU Pingli(Jieshou People's Hospital,Jieshou,Anhui Province,236500)
出处
《中国计划生育学杂志》
2023年第6期1326-1330,共5页
Chinese Journal of Family Planning
关键词
腹腔镜子宫切除术
超前镇痛
氟比洛芬酯
免疫功能
疼痛
术后恢复
Laparoscopic hysterectomy
Preemptive analgesia
Flurbiprofen axetil
Immune function
Pain
Postoperative recovery
