乌司他丁复合硬膜外镇痛泵对下腹部手术患者的影响

Effect of ulinastatin and patients-controlled epidural analgesia(PCEA) on postoperative pain and proinflamatory cytokine during lower abdominal surgery

目的:探讨围术期应用乌司他丁复合硬膜外镇痛泵对下腹部手术患者疼痛及炎性细胞因子的影响。方法:将120例下腹部手术的患者随机分入对照组(A)和乌司他丁复合硬膜外镇痛组(B),各60例,A组患者仅术后给予硬膜外镇痛泵,B组患者在围术期给予乌司他丁,并在术后予以硬膜外镇痛泵。结果:与A组比较,B组患者在T1(术后2小时)、T2(术后第1天)和T3(术后第3天)时间点静态和运动状态下VAS评分显著降低,在T1、T2和T3时点TNF-α和IL-6浓度均显著降低,术后疼痛与炎性细胞因子的变化有一定程度的相关(P<0.01)。结论:围术期使用乌司他丁复合硬膜外镇痛泵对下腹部手术患者有较好的镇痛作用,其机制可能与抑制炎性细胞因子的分泌有关。

Objective To object the effect of ulinastatin and patients -controlled epidural analgesia （PCEA） on postoperative pain and proinflamatory cytokine during lower abdominal surgery. Method 120 patients undergoing lower abdominal surgery were randomly divided into 2 groups, control group （ group A, n = 60） and preventive analgesia group （ group B, n = 60）. Patiems in group A received PCEA after operation. Patients in group B received ulinastatin and PCEA during operation. Results The VAS score in resting or active state, the expres- sion of proinflamatory cytokine in group B were significantly lower than those in group A, and the change of VAS score was associate with the expression of cytokine （P 〈 0. 01 ）. Conclusion Preventive analgesia by using ulinastatin and PCEA during operation has a better anal- gesic effect, and maybe related to the inhibition of cytokines expression.