帕瑞昔布钠复合芬太尼术后镇痛对妇科患者免疫功能的影响

Effects of postoperative analgesia with parecoxib sodium and fentanyl on the immunity of gynecological patients

目的观察帕瑞昔布钠复合芬太尼用于妇科患者术后静脉自控镇痛的效果及其对免疫功能的影响。方法将100例妇科患者随机分为两组,A组应用帕瑞昔布钠复合芬太尼术后镇痛,B组单纯用芬太尼。观察两组患者视觉模拟评分(VAS评分)及不良反应,分别于术前(T0),术毕(T1),术后12h(T2),术后24h(T3),术后48h(T4)测定其血浆IL-6、IL-10含量及T淋巴细胞亚群(CD3+、CD4+、CD8+)的水平及CD4+/CD8+比值。结果两组患者各时点VAS评分无统计学意义(P>0.05);A组术后不良反应发生率为20%,低于B组的46%(P<0.05);两组患者T0时点IL-6、IL-10含量及T淋巴细胞亚群(CD3+、CD4+、CD8+)的水平及CD4+/CD8+比值差异无统计学意义(P>0.05);在T3、T4时点,IL-6B组明显高于A组,IL-10B组低于A组,差异有统计学意义(P>0.05);两组在T1、T2时点CD3+、CD4+水平较T0下降,而CD8+含量较T0前均升高,但T3、T4时点A组CD3+、CD4+水平高于B组患者(P<0.05),而CD8+含量低于B组患者(P<0.05);两组T1、T2、T3、T4的CD4+/CD8+比值较T0均下降,但A组在T2、T3时CD4+/CD8+比值明显高于B组(P<0.05)。结论帕瑞昔布钠复合芬太尼应用于妇科患者术后镇痛不良反应少,对免疫功能影响较小。

Objective：To observe the effects of postoperative patient-controlled epidural analgesia on the immunity of gynecological patients.Methods：100 cases of gynecological patients were randomly divided into the observation group treated with parecoxib sodium and fentanyl and the contrast group treated with fentanyl.Both groups were evaluated by visual analogue scale（VAS） and the contents of plasma IL-6,IL-10 and Tlymphocyte subpopulations（CD3＋,CD4＋ and CD8＋ cell） were determined.Results：No significant differences were found between the two groups according to VAS（P0.05）.The incidences of side effects in Group B and Group A were 46% and 20%（P0.05） respectively.At T3,T4 the content of plasma IL-6 was found significantly higher but the content of plasma IL-10 was much lower in Group B than that in Group A.At T1,T2,the level of CD3＋ and CD4＋ was lower than that of T0,but the level of CD8＋ was higher.At T3,T4,Group A has higher level of CD3＋ and CD4＋,but has lower level of CD8＋.For the two groups,the CD4＋/CD8＋ ratio went down after operation,at T3,T4 Group A had higher CD4＋/CD8＋ ratio.Conclusion：The combined use of parecoxib sodium and fentanyl can produce good curative effects and have little effect on immunity.