不同时间给予氟比洛芬酯对结直肠肿瘤切除术患者术后炎性反应的影响

Administration of flurbiprofen axetil at different time in colorectal surgery:effect with postoperative cytokine release

目的探讨不同时间给予氟比洛芬酯(FA)注射液对结直肠肿瘤切除术患者术后血浆炎性因子表达的影响。方法选择择期结直肠肿瘤切除术患者40例,随机分为2组,每组20例。A组:手术开皮前30 min给予FA100 mg;B组:手术开皮后30 min给予FA 100 mg。术后均行舒芬太尼(SF)静脉自控镇痛(PCIA)。比较2组术前及术后6 h、24 h血浆白介素-2(IL-2)、白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子(TNF-α)、巨噬细胞—集落刺激因子(M-CSF)的浓度。结果与治疗前比较,2组术后6 h、24 h IL-2水平均降低,而IL-6和IL-10水平均升高(P<0.01);与B组比较,A组术后6 h、24 h时IL-2升高,IL-6降低(P均<0.05);与B组比较,A组术后6 h IL-10水平升高(P<0.05)。2组患者各时间点TNF-α和M-CSF水平差异均无统计学意义(P>0.05)。结论手术前静脉注射FA 100 mg镇痛,同时复合SF静脉自控镇痛,可降低结直肠肿瘤切除患者术后促炎因子的表达,同时提高抗炎因子水平,并促进患者术后免疫功能的恢复。

Objective To explore the different time to administrate the flurbiprofen axetil（FA） injection effects on the expression of plasma inflammatory cytokines in colorectal tumor resection patients.Methods Selected elective colorectal cancer resection patients（n s40）,they were randomly divided into 2 groups,20 patients in each group.Croup A;open skin before operation for 30 min FA 100 mg;group B：after operation skin for 30 min FA 100 mg.Postoperative sufentanil（SF） were performed in patient controlled intravenous analgesia（PCIA）.Comparison of 6 h,24 h of plasma interleukin 2（IL-2）,interleukin 6（IL-6）,interleukin 10（IL-10）,tumor necrosis factor（TNF-α）,mocrophage-colony stimulating factor（M-CSF） concentration between the 2 groups before and after the operation.Results Compared with before treatment,the 2groups＇ IL 2 levels after6 h,24 h were lower,while IL-6 and IL-10 levels were elevated（P〈 0.01）;compared with group B,after 6 h,24 h,group A＇s IL-2 increased,IL-6 reduced（P 〈0.05）;and compared with group B,after operation for 6h,group As IL-10 levels was increased（P 〈0.05）.Patients in the 2 groups at each time point,TNF-α and M-CSF levels showed no statistically significant differences（P 〉0.05）.Conclusion Intravenous injection of FA 100 mg before operation,and combined with patient-controlled intravenous SF analgesia can reduce the expression of inflammatory factor on colorectal tumor patients,while improving the anti-inflammatory cytokines,and promote the recovery of immune function of postoperative patient.