注射用帕瑞昔布钠超前镇痛对开腹手术病人血清白介素-6的影响

The injection eases the pain in advance with the handkerchief auspicious past cloth sodium starts out from opposite directions folio the abdomen sur- gery patient blood to lie between purely the dement -- 6 influences

目的：本文旨在探讨在开腹手术中应用帕瑞昔布超前镇痛。测定血清IL--6的变化，以此探讨帕瑞昔布对开腹手术围术期致炎因子IL-6的影响。方法：选择胃癌病人30例，择期行胃癌根治术，随机分为两组：A组（实验组）和B组（对照组），两组均采用吸入麻醉，A组（实验组），术前30分钟静脉注射帕瑞昔布20mg，手术结束时静脉注射帕瑞昔布40mg，B组（对照组）不做任何处理。术后接PCA泵，芬太尼1mg＋生理盐水至100ml，每小时2ml，负荷量0．5ml间隔15分钟。分别于入室后（T1），手术开始后3小时（T2），术后8小时（T3）和术后24小时（T4），四个时同点采取末梢静脉血3ml，用IL--6试剂盒采用放免法测定标本中血清IL--6的浓度。结果：A组T2，T3，T4时间点IL--6值与术前相比有显著差异P〈0．05。与B组相比差异有显著性。这说明帕瑞昔布超前镇痛对血清IL-6浓度的升高有-定程度的抑制作用。术后并发征发生率两组间差异显著。帕瑞昔布组显著降低阿片类药物相关不良反应发生率。结论：在开腹手术中，术前静脉给予帕瑞昔布超前镇痛，效果确切，降低了术后疼痛反应，抑制了围术期致炎因子IL-6的升高，对手术创伤后应激时细胞因子反应具有调控作用。

Objeictive..This article is for the purpose of discussing in holds in the abdomen surgery to ease the pain in advance using the handkerchief auspi- cious past cloth. The determination blood serum IL-6 change, starts out from opposite directions folio the abdomen surgery by this discussion handkerohief aus- picious past cloth to encircle the technique time to send inflammation factor IL-- 6 the influence. Methods： Chooses the stomach cancer patient 30 examples,picks an auspicious date the good stomach cancer root governing skill, divides into two groups stochastically： A group （experimental group） and B group （control group） ,two groups use the inhalated narcosis, A group （experimental group）, technique first 30 minute intravenous injection handkerchief auspicious past cloth 20mg, the surgery ended when the intravenous injection handkerchief auspicious past cloth 40m g, B group （control group） does not make any processing. After the technique meets the PCA pump,the fragrance too Nepal ling＋ physiological saline to 100ml,each hour 2ml,load 0. 5ml is separated 15 minutes. In enters the inner rooms separately latter （T1） ,the surgery starts the latter 3 hours （T2） ,the technique latter 8 hours （T3） and the technique latter 24 hours （T4）, four time spots adopt end venous blood 3ml,usea with the IL--6 reagent box puts exempts in the law determination specimen the blood serum IL--6 density. Results：A group of T2, T3, T4 time sdects in front of the IL--6 value and the technique compares has remarkable difference P〈0. 05. Compares the difference with B group to have the significance. This indicated the handkerchief auspicious past cloth eases the pain in advance to the blood serum IL--6 density aseerasion has certain degree inhibitory action. After the technique drafts the formation rate two groups of between differences to be remarkable concurrently. The hand- kerchief auspicious past cloth group obviously reduces the meconium class medicine correlation to respond the formation rate not good. Condesiens：In holds in the abdomen surgery, in front of the technique the vein gives the handkerchief auspicious past cloth to ease the pain in advance,the effect was accurate,after re- duces the technique the ache to respond,suppressed has encircled the technique time to send irfflammation factor IL--6 the ascension,alter surgery wound when stress the cell factor responded had the regulative function.