诺扬、舒芬太尼、曲马多在颚咽成形术后镇痛对患者IL-2的影响分析

Effect of Connaught Yang,Sufentanil,Tramadol Analgesia on IL-2 of Patients after Angioplasty Pharyngeal in Jaw

目的探讨诺扬、舒芬太尼、曲马多镇痛对颚咽成形术后患者血浆白细胞介素2(interleukin 2,IL-2)的影响。方法将30例欲行颚咽成形术患者随机分为诺扬组(A组),舒芬太尼组(B组),曲马多组(C组),比较麻醉前30min、术时、术后24 h、48 h、72 h血浆中IL-2水平。并评价镇痛效果。结果三组术毕、术后24 h、48 h的IL-2水平低于麻醉前30 min(P<0.05或0.01),术后72 h的IL-2与麻醉前比较差异无统计学意义(P>0.05),B组术毕、术后24 h、48h IL-2水平一直高于A、C两组(F=3.872,P=0.026);三组术后2 h、24、48的VAS评分高于术前(P<0.01),并随着术后时间的延长,VAS评分在术后2 h的基础上逐渐降低,术后72 h VAS评分与术前无差异,B组术后2、24 h、48的VAS评分一直低于A、C两组(F=3.972,P=0.024);三组不良反应有恶心呕吐、皮肤瘙痒、头晕,三组差异无统计学意义(χ2=2.864,P=0.371),经对症治疗及综合护理后,症状基本缓解。结论舒芬太尼镇痛作用较诺扬和曲马多起效快,不良反应小,临床值得参考。

Objective To investigate the effect of Connaught Yang, sufentanil, tramadolanalgesia on velopharyngem forming plasma interleukin 2 （IL-2） in postoperative patients.Methods A total of 30 patients with desire for jaw pharyngoplasty were randomly divided into Connaught Yang Group （group A） , sufentanil group （group B） , tramadol group （C group） . The IL-2 levels in plasma30min before anesthesia, during surgery, 24 h, 48 h, 72 h postoperative were compared. Analgesic effect was evaluated.Results In the three groups. IL-2 levels after operation, 24 h, 48 h postoperative were less than that 30min before anesthesia （P〈0.05 or 0.01） .There was no significant difference in IL-2 level 72 h postoperative eompared with that pre-anesthesia （P〉0.05） , IL-2 levles in group B after operation, and 24 h,48 h post operative were higher than those in the A group （F = 3.872,P = 0.026）. In the three groups VAS score 2 h, 24 h, 48 h postoperative were higher than that before operation （P（0.01）. Along with the extension of time, VAS score decreased. VAS score 72 h postoperative was not different compared with that before surgery. VAS scores in group B 2 h, 24 h, 48 h postoperative were lower than those in A, C groups （F = 3.972,P = 0.024）. The adverse reactions included nausea and vomiting, skin itching, dizziness and no significant difference were observed among three groups （x^2 = 2.864,P = 0.37l） . The symptomatic treatment and comprehensive care can ease the symptoms.Conclusion Sufentanil analgesia has quick effect, less adverse reactions compared with tramadol and Connaught Yang, and it is worthy of clinical reference.