氟比洛芬酯自控镇痛对妇科术后应激反应的影响

Effects of the flurbiprofen axetil for postoperative patient-controlled intravenous analgesia on stress response after gynecological surgery

目的观察应用氟比洛芬酯行患者自控静脉镇痛（PCIA）对妇科腹腔镜术后应激反应的影响。方法择期行妇科腹腔镜手术患者120例，按随机数字表法分为氟比洛芬酯组和舒芬太尼组，每组各60例，术毕F组予氟比洛芬酯4mg／kg，S组予舒芬太尼1．5μg／kg，分别用0．9％氯化钠稀释至150ml行PCIA。分别于术前、术毕、术后48h检测肿瘤坏死因子（TNF）．d及自细胞介素（IL）-6、IL-8、IL-10水平。结果两组术后疼痛视觉模拟评分（VAS）均小于4分，组间比较差异无统计学意义（尸〉0．05）。两组患者组内和组间TNF-0l比较差异均无统计学意义（P〉0．05）。两组术毕、术后48hIL-6、IL-8均较术前明显升高（P〈0．05），但氟比洛芬酯组[IL-6分别为（18．39±3．01）、（13．43±3．11）ng／L，IL-8分别为（24．25±2．75）、（15．31±2．65）ng／L]明显低于舒芬太尼组[IL-6分别为（38．02±2．95）、（23．28±2．43）ng／L，IL-8分别为（37．56±2．97）、（24．86±3．11）ng／L]（P〈0．05）。两组术毕、术后48hIL-IO均较术前明显升高（P〈0．05），但术后48h氟比洛芬酯组[分别为（26．72±4．41）、（21．03±2．99）．g／L]明显高于舒芬太尼组[分别为（22．18±3．21）、（16．89±4．48）ng／L]（P〈0．05）。结论氟比洛芬酯用于妇科腹腔镜术后PCIA效果满意，能减轻术后应激反应。

Objective To observe the effects of flurbiprofen axetil postoperative patient-controlled intravenous analgesia （PCIA） on stress response in patients undergoing gynecological laparoscopy operation. Methods One hundred and twenty ASA I - II gynecological laparoscopy operation patients were randomized to two groups, 60 cases in each group. Group F received flurbiprofen axetil 4 mg/kg while group S were given sufentanil 1.5 p. g/kg for postoperative PCIA. Tumor necrosis factor- α （TNF- α ） and interleukin （IL）-6, IL-8, IL- 10 were estimated preoperative （T0）, operation termination （T1） and 48 h after operation （T2）. Results VAS scores were less than 4 scores and no significant difference between two groups. There was no significant difference in TNF- α intraclass and interclass between two groups（P 〉 0.05 ）. IL-6, IL-8, IL-10 in two groups were significantly higher at T1 and T2 than those at To （P 〈 0.05 ）. IL-6, IL-8 at TI and T2 were lower in group F than those in group S [T1 and T2：IL-6 was （ 18.39 ±3.01 ）, （ 13.43±3.11 ） ng/L,IL-8 was （24.25 ± 2.75）, （15.31 22.65） ng/L in group F;IL-6 was （38.02 ± 2.95）, （23.28 ±2.43） ng/L,IL-8 was （37.56 ± 2.97 ）, （24.86 ± 3.11 ） ng/L in group S ] （P 〈 0.05 ）. While IL-10 was significantly higher and lasted longer in group F than that in group S [（26.72 ± 4.41 ）, （21.03 ± 2.99） ng/L in group F; （22.18 ± 3.21 ）, （16.89 ± 4.48） ng/L in group S ] （P 〈 0.05）. Conclusion PCIA with flurbiprofen axetil in gynecological laparoseopy operation patients can alleviate inflammatory response.