羟考酮注射液对腹腔镜结直肠癌患者术后镇痛效果的影响

Influence of oxycodone injection on postoperative analgesia effect for patients having received laparoscopic radical operation for colorectal cancer

目的探讨羟考酮注射液对腹腔镜结直肠癌患者术后镇痛、炎症因子及细胞免疫功能的影响。方法以我院2013年3月~2015年3月择期行腹腔镜结直肠癌根治术80例患者为研究对象,术后均连接镇痛泵镇痛处理,根据不同镇痛药物将其分为羟考酮组与吗啡组,各40例,比较两组不良反应、不同时间点[镇痛后1 h（T0）、6 h（T1）、12 h（T2）、24 h（T3）、48 h（T4）]静息VAS评分、Ramsey镇静评分及血清IL-6、IL-10水平和免疫功能的变化。结果羟考酮组T1、T2时Ramsey镇静评分明显低于吗啡组（P〈0.05）;两组不同时间点VAS评分差异无统计学意义（P〉0.05）;羟考酮组术后T2、T3、T4时IL-10、CD3＋、CD4＋水平均明显高于吗啡组（均P〈0.05）;羟考酮组呕吐、呼吸抑制发生率分别为15.0%、5.0%,显著低于吗啡组的35.0%、20.0%（P〈0.05）。结论羟考酮注射液对腹腔镜结直肠癌患者术后镇痛效果与吗啡类似,但前者能明显减少呕吐、呼吸抑制发生,且能有效调节IL-6、IL-10水平,对机体细胞免疫功能有一定的保护作用。

Objective To explore the influence of oxycodone injection on postoperative analgesia effect,inflammatory factor and cellular immune function of patients having received laparoscopic radical operation for colorectal cancer（LROCC）.Methods A total of80 patients,who had received LROCC from March 2013 to March 2015 in our hospital and had been treated with patientccontrolled analgesia upon the operation,were divided into oxycodone and morphine groups（n =40,respectively） according to the different analgesic drugs in order to compare the adverse reactions,and changes in resting VAS scores,Ramsey scores,serum IL-6 and IL-10 and immunologic function of the two groups at different time points [1 h（T0）,6 h（T1）,12 h（T2）,24 h（T3） and 48 h（T4）].Results The Ramsey scores of oxycodone group at T1 and T2were much lower than those of morphine group（P〈0.05）; there was no significant difference between the VAS scores of the two groups at different time points（P〈0.05）; the IL-10,CD3＋and CD4＋of oxycodone group at T2,T3 and T4were much higher than those of morphine group（P〉0.05）; the incidence rate of vomiting and respiratory depression in oxycodone group were 15.0% and 5.0% respectively,which were significantly lower than the 35.0% and 20.0% of morphine group（P〈0.05）.Conclusion Oxycodone injection shows similar postoperative analgesic effect for patients received LROCC as morphine.The former,however,can obviously decrease the incidence rate of vomiting and respiratory depression,effectively adjust IL-6 and IL-10 and have certain protective effect on cellular immunity function.