氟比洛芬酯对喉癌喉裂开术患者围术期细胞因子及术后疼痛的影响

Effect of lipid microspheres flubiprofen axetil injection on perioperative cytokines and postoperative pain in patients undergoing laryngofission for laryngeal carcinoma

目的观察氟比洛芬酯对喉癌喉裂开术患者术后疼痛及围术期细胞因子的影响。方法择期行喉癌喉裂开术患者60例,随机均分为三组:术毕前10min分别静脉注射氟比洛芬酯1.0mg/kg(F1组)、氟比洛芬酯1.5mg/kg(F2组)、生理盐水5ml(C组)。VAS评分评定术后1、2、4、6、8、12、24h的疼痛程度。监测术前、术毕和术后6、24h血浆白细胞介素(IL)-2、可溶性白细胞介素-2受体(SIL-2R)、IL-6、IL-10的浓度。结果与术前比较,C组SIL-2R水平在术后6h明显降低、术后24h明显升高;F1、F2组SIL-2R水平明显降低;三组IL-6、IL-10水平明显升高和IL-2水平明显降低(P<0.05)。与C组比较,术后1、2、4h时F2组VAS明显降低,术后4h时F1组VAS明显降低(P<0.05);术后6、24h时F1、F2组的IL-10水平和术后24h时的IL-2水平明显升高,且F2组明显高于F1组(P<0.05);F1、F2组在术后6h时的IL-6水平和术后6、24h时SIL-2R水平明显降低,且F2组明显低于F1组(P<0.05)。结论 1.5mg/kg氟比洛芬酯能有效地平衡细胞因子,缓解术后的免疫损伤,具有免疫保护作用。

Objective To investigate the analgesic effect and impact on the eytokines response of the lipid microspheres flurbiprofen axetil injection [n patients undergoing cancer of larynx transection surgery. Methods Sixty patients scheduled to take cancer of larynx transection surgery were randomly divided into 3 groups, the patients was respectively administered 1.0 mg/kg flurbiprofen axetil （group F1 ）, 1.5 mg/kg flurbiprofen axetil （group F2 ） and 5 ml 0. 9 % normal saline solution （group C） at 10 rain before the end of operation to close. The analgesic effect assessed by visual analog scale （VAS） at rest at six time point, 1,.2, 4, 6, 8, 12 and 24 h after operation. Furthermore, the venous blood was drawn to determine the level of IL-2, SIL-2R, IL- 6,IL- 10 at four time point, before the induction of anesthesia, at 15min before the end of operation to close and at 12,24 h after the surgery to determine the level of IL-2,SIL-2R, IL-6, IL-10. Results Compared with the level before the induction of anesthesia, except in group C the level of SIL-2R in group C were risedas decreased at 6 h after the surgery, but increased at 24 h after the surgery; SIL-2R in group F1, F2 were decreased significantly; 24 h after the surgery, the levels of IL-2, SIU-2R were droped and the levels of IL- 6,IL-10 were rised increased but SIL2R was decreased in three groups（P〈0. 05）. Compared with group C, VAS were lower in group F2 ; at 1,2,4 h after the surgery, VAS was lower in group F1 at 4 h after the surgery （P〈0. 05）; IL-10 was higher in group F1 ,F2 at 6, 24 h after the surgery, IL2 was higher in group F1 ,F2 at 6, 24 h after the surgery, furthermore, which in group F2 was higher than which in group F1 （P〈0. 05）; IL-6 of group F1, F2 at 6 h after the surgery was decreased at after the surgery, SIL-2R of group F1,F2 at 6, 24 h after the surgery were decreased, furthermore, which in group F2 was lower than which in group F1 （P〈0.05）. Conclusion 1.5mg/kg flurbiprofen axetil could effectively balance cytokines, alleviate postoperative immune injury, possess immunization protection.