氯诺昔康对腹腔镜阑尾切除术患者术后炎性反应的作用

Effect of lornoxieam on postoperative inflammatory reaction in patients undergoing laparoscopic appendectomy

目的观察氯诺昔康对腹腔镜阑尾切除术后炎性反应的作用。方法选择ASA级Ⅰ～Ⅱ在联合腰硬麻醉下行腹腔镜阑尾切除术的患者40例，随机分为观察组和对照组，每组20例。观察组麻醉前静脉注射氯诺昔康8mg（用注射用水2ml稀释），对照组静脉注射用水2ml。于L2-3间隙穿刺行腰硬联合麻醉，调节阻滞平面到T6节段，术中静脉注射哌替啶、氟哌利多和安定维持镇静。于手术前1小时和术后1天抽取外周静脉血，进行白细胞计数，并测定血中C反应蛋白（CRP）浓度。结果两组患者术后l天的白细胞计数和CRP浓度较术前明显下降（P〈0．05）；两组间比较，在术后1天，白细胞计数观察组明显低于对照组（5．4±3．7）比（7．6±3．2）（P〈0．05）CRP浓度观察组也明显低于对照组（6．4±3．7）比（9．6±4．1）（P〈0．05）。结论麻醉前静脉注射氯诺昔康可减轻腹腔镜阑尾切除术患者术后早期炎性反应。

Objective To investigate the effects of lornoxicam on postoperative inflammatory reaction in patients undergoing laparoscopic appendectomy. Methods Sixty ASA Ⅰ～Ⅱpatients undergoing laparoscopic appendectomy were assigned to study group and control group （ 24 for each ）. The study group received intravenous loronoxicam of 8 mg diluted with normal saline of 2ml before anesthesia, and the control group received the same volume of normal saline. All the patients were anesthetized with combined spinal and epidural blockage and tranquilized with pethedine, droperidol, and diazepam. Peripheral vein blood were extracted one hour before surgery and one day after operation to measure leukocyte count; the concentration of C reaction protein （ CRP ） was detected. Results Leukocyte count and CRP concentration were markedly decreased ond day after surgery in both groups （ P〈 0.05 ）. Leukocyte count and CRP concentration were significantly lower in the study group than in the control gToupt[（ 5.4 ±3.7 ） vs. （ 7.6 ±3.2 ） and （ 6.4 ±3.7 ） vs.（ 9.6 ±4.1 ）, P 〈 0.05 for both comparisons]. Conclusions Intravenous lornoxicam before anesthesia can suppress inflammatory reaction during early postoperative stage in patients undergoing laparoscopic appendectomy.