自控静脉镇痛法对改良悬雍垂腭咽成形术术后患者IL-2、IL-6的影响

Effect of patient-controlled intravenous analgesia for Han-uvulopalatopharyngoplasty surgery on plasma IL-2 and IL-6

目的:探讨自控静脉镇痛对H-UPPP术后的镇痛效果和患者IL-2、IL-6的影响。方法:选取48例行H-UPPP手术患者随机分为实验组24例(术后应用静脉自控进行镇痛)和对照组24例(口服尼美舒利0.1 g进行镇痛)。观察患者术后6 h、24 h和48 h静息和吞咽时VAS评分。检测麻醉前、术后3个时间点的IL-6、IL-2含量。结果:实验组术后各时间点VAS评分均较对照组低(P<0.05)。两组IL-6含量术后较术前提高(P<0.05),对照组术后IL-6升幅比实验组高,两组比较有统计学意义(P<0.05)。实验组血清IL-2含量手术前后差异无统计学意义,对照组术后IL-2含量较术前降低(P<0.05)。结论:在H-UPPP术后应用自控静脉镇痛可获得确切、安全的镇痛效果,有利于维持抗炎和促炎因子之间的稳定,使术后疼痛对免疫的抑制减轻。

Objective： To evaluate the analgesic efficiency of patient-controlled intravenous analgesia（PCIA）after Han-uvulopalatopharyngoplasty（H-UPPP）and its effect on serum levels of interleukin-2and interleukin-6. Methods： 48 patients undergoing H-UPPP surgery were randomly divided into two groups： experimental group（n=24, patient-controlled intravenous analgesia）and control group（n=24,Nimesulide 0.1 g,P.O）. The VAS was observed in the postoperative 8 h, 24 h and 48 h at both rest and swallow state. The levels of IL-2 and IL-6 in serum were measured in the preoperative and postoperative 8h, 24 h and 48 h. Results： The VAS score of control group was significant higher than that of experimental group（P 0.05）.The level of IL-6 was increased significantly in the two groups comparing with the level before anesthesia（P 0.05）, IL-6 in control group increased significantly compared with that in experimental group at postoperation（P 0.05）. The level of IL-2 in experimental group were not significantly different in the preoperative and postoperative. The postoperative level of IL-2 in controlgroup significantly reduced compared with that in the preoperative（P 0.05）. Conclusion： PCIA can provide safe and satisfactory analgesia for patients with OSAHS after H-UPPP. PCIA is conducive to maintaining the stability of pro/anti-inflamatory cytokines, reducing the immune suppression.