摘要
【目的】探讨术前输注氟比洛芬酯(凯纷)对子宫切除术患者围术期血浆促炎因子白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)的影响。【方法】择期行子宫切除术患者60例,ASAⅠ~Ⅱ级,随机分为凯纷组和芬太尼两组各30例。凯纷组在手术切皮前5min静脉输注凯纷1mg/kg,芬太尼组在手术切皮前5rain静脉输注芬太尼1μg/kg,术毕两组静脉自控镇痛(PCIA)。锁定时间15min,视觉模拟评分法(VAS)行术后12、24及48h静止和活动评分,分别在开放静脉前(T1)、手术结束时(T2)、术后24h(T3)、术后48h(L)采取外周静脉血4ml测定血浆IL-6、IL-8、TNF-α浓度。【结果】两组患者在各时间点的BP、HR、RR、SPOz差异无显著性(P〉0.05),两组患者在术后12h(T2)和术后24h(T3)活动时视觉模拟评分(vAS值)凯纷组低于芬太尼(P〈O.05);两组IL-6、IL-8、TNF-α水平在T2时显著升高,与本组T1时比较差异具有显著性(P〈0.05);组间比较差异不具有显著性(P〉0.05),在T3时比较凯纷组明显低于芬太尼组(P〈O.05),在T4时比较差异不具有显著性(P〉O.05);两组TNF-α在T2时比较差异不具有显著性(P〉0.05),在T。和‘r4时凯纷组明显低于芬太尼组(P〈O.05)。【结论】术前输注凯纷能明显降低子宫切除术患者围术期血浆促炎因子IL-6、IL-8、TNF-α的水平,但不能减轻手术创伤激活了损伤部位的炎症细胞释放炎症介质。
[Objective]To explore the effect of intravenous injection of flurbiprofen axetil before hysterectomy on the expression of IL-6, IL- 8 and TNF-α during perioperative period. [Methods] Sixty elective hysterectomy patients were randomly divided into 2 groups with 30 cases for each. Flurbiprofen axetil group received intravenous injection of flurbiprofen axetil lmg /Kg at 5min before surgical incision and fentanyl group received intravenous injection of fentanyl 1μg/kg at 5min before surgical incision. Both groups received fentany 20〉g/kg/100 mL by patient-con trolled intravenous analgesia(PCIA) (bolus 0. 5 mL,lock time for 15min, back ground infusion at 2 ml/h). Pain scales was assessed by visual analog scales(VAS) at 12,24,48h after surgery. Peripheral venous blood samples were respectively taken before anesthesia(T1 ), at the end of operation(T2 ), at 24h(T3 ) and 48h(T4 ) after.operation. The levels of IL-6, IL-8 and TNF-α in the plasma were detected. [Results]There was no significant difference in BP, HR,RR and SPO2 between two groups at all time points( P 〈0.05). The VAS of activity at 12h and 24h after operation in flurbiprofen axetil group was significantly lower than that in fentanyt group, and there was significant difference between two groups( P 〈0.05). The levels of IL-6, IL-8 and TNF-α in both groups increased the most high at T2 , and there was significant difference between at T1 and T2 ( P 〈0.05). There was no significant differ- ence on the levels of II. 6 and IL-8 between two groups at T2 ( P 〉0.05), but there was significant difference at T4( P 〈0.05). The levels of IL 6 and IL-8 at T4 in flurbiprofen axetil group were significantly lower than those in fentanyl group, but there was no significant difference( P ~0.05). There was no significant difference on the level of TNF ~ between two groups at Tz ( P ~0.05). The level of TNF-α at T3 and T4 in flurbiprofen axetil group was significantly lower than that in fentanyl group, and there was significant difference between two groups( P 〈0.05). [Conclusion] Intravenous injection of flurbiprofen axetil before hysterectomy can decrease the expression of IL-6, IL-8 and TNF-α during perioperative period, but can not reduce the release of inflammation mediators in inflammatory cells caused by surgical trauma.
出处
《医学临床研究》
CAS
2009年第9期1603-1605,共3页
Journal of Clinical Research
基金
[基金项目]常德市科技局社会发展基金资助项目(科目编号20604,项目编号2008sk02)