喷他佐辛术后镇痛对患者免疫及感染的影响

Impact of postoperative analgesia with pentazocine on patients′ immunity to infections

目的研究喷他佐辛术后镇痛对患者术后免疫及感染的影响,以期为临床提供参考。方法选取2010年10月-2013年7月入院诊治的60例下肢骨折患者,随机分为试验组和对照组,各30例;其中试验组应用喷他佐辛术后镇痛,对照组应用芬太尼术后镇痛,观察两组患者的术后镇痛效果以及对免疫和感染的影响。结果试验组RSS评分在术后4 ～48h内一直维持在2 ～4分满意镇痛范围内,对照组在术后4、8h满意镇痛,而在术后12 ～48h的镇痛效果逐渐减低;VAS评分中,两组患者均在术后8h出现峰值,在术后8 ～48h均呈逐渐降低形式,试验组评分普遍低于对照组;白细胞介素-6（IL-6）、白细胞介素-10（IL-10）水平在术前无差异,均在术后24h达到峰值,后又降低到略高于术前水平,其中试验组的IL-6水平普遍低于对照组,而IL-10水平普遍高于对照组,两组比较差异有统计学意义（P〈0.05）。结论喷他佐辛用于术后镇痛作用显著,药效维持时间长,镇静效果俱佳,并且能一定程度提高患者免疫力和抗感染能力。

OBJECTIVE To study the effect of postoperative analgesia with pentazocine on patients′immunity to infections so as to provide guidance for clinical treatment.METHODS Totally 60patients with lower extremity fractures,who were hospitalized for treatment from Oct 2010to Jul 2013,were enrolled in the study and randomly divided into the study group and the control group,with 30cases in each,then the study group was treated with pentazocine for postoperative analgesia,the control group was treated with fentanyl for the postoperative analgesia,the effect of the postoperative analgesia and its impact on immunity to infections were observed and compared between the two groups.RESULTS The RSS score of the study group maintained a satisfactory analgesia scope within 4-48hours after surgery,with the score ranging between 2and 4points;the control group achieved the satisfactory analgesia effect within 4or 8hours after surgery,which was decreased within 12-48hours after surgery. The VAS score of both groups peaked within 8hours after surgery and showed a downward trend within 8-48 hours after surgery,and the VAS score of the study group was generally lower than that of the control group.The levels of interleukin-6（IL-6）and interleukin-10（IL-10）showed no difference before surgery and reached the peak 24hours after surgery,then decreased to the levels that were slightly higher than before surgery;the IL-6level of the study group was lower than that of the control group,while the IL-10level of the study group was higher than that of the control group,with statistical significance（P〈0.05）.CONCLUSIONPentazocine can achieve significant effect on postoperative analgesia and improve,to certain extent,the patients′immunity to the infections, with the efficacy maintaining for a long time.