摘要
目的:探究瑞芬太尼联合纳布啡对腹腔镜子宫肌瘤切除术患者血流动力学及血清神经生长因子(NGF)、S100β蛋白的影响。方法:将本院2023年9月-2024年11月收治的拟行腹腔镜子宫肌瘤切除术患者108例,随机分为联合组和对照组各54例,对照组给予瑞芬太尼麻醉,联合组在对照组基础上联合纳布啡。比较两组术前(T0)、术后6h(T1)、术后24h(T2)的视觉模拟评分法(VAS)、Ramsay评分,心率(HR)、平均动脉压(MAP)、S100β蛋白、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6),手术前后NGF、P物质、前列腺素E2(PGE2)、皮质醇(Cor)、去甲肾上腺素(NE)、随机血糖(GLU)。结果:与T0相比,T1、T2两组VAS、Ramsay评分均减小,且联合组小于对照组(P<0.05);T1、T2两组MAP先升后降,HR、hs-CRP、S100β、IL-6逐渐升高,术后NGF、P物质、PGE2、GLU、NE、Cor水平上升,但联合组均低于对照组(均P<0.05)。结论:瑞芬太尼联合纳布啡用于腹腔镜子宫肌瘤切除术患者,有利于增强镇静效果,降低疼痛,减少对患者炎症、应激反应的影响。
Objective:To discuss the effects of remifentanil combined with nalbuphine used in laparoscopic myomectomy of patients on their hemodynamics and their levels of serum nerve growth factor(NGF)and S100β and S100β.Methods:From September 2023 to November 2024,108 patients with uterine fibroids who wanted laparoscopic myomectomy in the hospital were randomly divided into the study group(n=54)and control group(n=54).The patients in the control group were given remifentanil anesthesia during surgery,while the patients in the study group were given remifentanil combined with nalbuphine anesthesia during surgery.The scores of visual analogue scale(VAS)and Ramsay before surgery,the values of heart rate(HA)and mean arterial pressure(MAP),and the levels of S100β protein,hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)before surgery(T0),after surgery(T1),in 6h after surgery(T2)and in 24h after surgery,and the levels of NGF,substance P,prostaglandin E2(PGE2),cortisol(Cor),norepinephrine(NE),and random blood glucose(GLU)before and after surgery of the patients were compared between the two groups.Results:The VAS and Ramsay scores of the patients in both groups at T1 and at T2 were significantly lower than those of the patients at T0,and which of the patients in the study group were significantly lower than those of the patients in the control group(P<0.05).The MAP value of the patients in both groups at T1 and T2 had increased firstly and then decreased,while the HR value,and the levels of hs-CRP,S100β and IL-6 at T1 and T2 of the patients in both groups had increased gradually.The levels of NGF,substance P,PGE2,GLU,NE and Cor of the patients in both groups after surgery had increased significantly,and which of the patients in the study group were significantly lower than those of the patients in the control group(all P<0.05).Conclusion:Remifentanil combined with nalbuphine used in laparoscopic myomectomy of the patients is beneficial for enhancing their sedative effect,reducing their pain and minimizing the impacts on their inflammation and stress response.
作者
刘俊利
LIU Junli(Rongxian People's Hospital,Sichuan Province,643100)
出处
《中国计划生育学杂志》
2025年第10期2280-2285,共6页
Chinese Journal of Family Planning
