不同镇痛方式对烧伤植皮患者术后血浆炎症因子水平的影响

Effect of different analgesia on postoperative plasma inflammatory factor level of patients with burn skin graft

目的:观察双氯芬酸钠组与盐酸哌替啶对烧伤植皮患者术后血浆炎症因子水平的影响。方法:临床纳入烧伤植皮患者70例,根据术后镇痛药物的不同分为研究组与对照组。研究组给予双氯芬酸钠,对照组给予盐酸哌替啶。采用疼痛视觉模拟量表(VAS)对两组患者镇痛前后进行疼痛评分。观察两组患者镇痛前后血浆白细胞介素-6、8(IL-6、IL-8)以及肿瘤坏死因子(tumor necrosis factor-α,TNF-α)的水平以及两组患者镇痛期间不良反应发生情况。结果 :镇痛前,两组患者疼痛VAS评分无统计学差异(P>0.05)。给药1、2、4h后,研究组疼痛VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。研究组给药后12h IL-6、TNF-α水平明显低于对照组(P<0.05);研究组给药后8、12、24hIL-8水平明显低于对照组(P<0.05)。镇痛期间,研究组恶心呕吐以及嗜睡的发生率高于对照组,差异有统计学意义(P<0.05)。结论 :双氯芬酸钠组用于烧伤植皮患者术后镇痛,起效时间快,能够改善患者血浆炎症因子水平,值得推广。

Objective： To observe the effect of diclofenac sodium and pethidine hydrochloride on plasma inflammatory factor levels of patients with burn skin graft. Method： A total of 70 patients with burn skin graft were selected and divided into research group and control group based on different postoperative analgesia drugs. Patients in research group were given with diclofenac sodium, while patients in control group were given with pethidine hydrochloride. Pain scores were assessed by using VAS. Plasma interleukin-4 （IL-4）, IL-6, IL-8, IL-10 and tumor necrosis factor （TNF-α） levels were determined before and after analgesic administration. Analgesic adverse reactions of both groups were observed. Results： Before analgesia, there was no significant difference in VAS scores of both groups （P〈 0.05）. After 1 h, 2 h, 4 h, VAS scores of the research group were significantly lower than those of the control group （P 〈0.05）. After 12 h, IL-6, and TNF-α levels of research group were significantly lower than those of control group （P 〈0.05） ; after 8 h, 12 h, and 24 h, IL-8 levels of the research group were significantly lower than the control group （P〈0.05）. During analgesia, nausea, vomiting, and lethargy of the research group were significantly higher than the control group （P 〈0.05）. Conclusions： For patients with skin burn grafts, diclofenacsodium has rapid onset time, and can improve plasma inflammatory factor levels. It is worthy clinical promotion.