复方丹参注射液与芬太尼合剂联合高乌甲素对直肠癌根治术患者的术后镇痛效果

Analgesic effects of compound salvia miltiorrhiza injection and fentanyl combined with lappaconitine in patients after radical resection of rectal carcinoma

目的探讨复方丹参注射液与芬太尼合剂联合高乌甲素对直肠癌根治术后疼痛患者的镇痛效果。方法直肠癌根治术患者90例，采用随机数字表法分为联合组（47例）和单纯组（43例）；单纯组给予高乌甲素36mg、芬太尼0．5mg、氟哌利多（droperidol）5mg溶于0．9％氯化钠注射液，配制成100ml的镇痛液合剂进行术后镇痛；联合组在单纯组的基础上加用复方丹参注射液4mg。观察两组患者术后不同时间VAS疼痛评分、Ramsay镇静评分以及术后48hCOX-1、COX-2、IL-18、TNF-α表达。结果两组患者治疗后VAS与Ramsay评分均显著下降，联合组下降程度优于单纯组（P〈0．05）；两组患者术后4、8、24、72h时VAS与Ramsay评分达到0-3和0-1分的例数呈现递增的趋势，8、24、72h时联合组VAS与Ramsay评分达到0-3和0-1分的例数明显高于对照组（P〈0．05）；两组患者治疗后COX-1、COX-2、IL-1β、TNF-α表达均显著下降，联合组下降程度显著优于单纯组（P〈0．05）。结论应用复方丹参注射液与芬太尼合剂联合高乌甲素对直肠癌根治术后疼痛患者镇痛安全且效果好。

Objective To explore the analgesic effects of compound salvia miltiorrhiza injection and fentanyl combined with lappaconitine in patients after radical resection of rectal carcinoma. Methods Ninety patients undergoing radical resection for rectal cancer were randomly divided into combination group （47 cases） and single group（43 cases） according to the random digital table method. The patients in single group were treated with lappaconitine 36 mg, fentanyl 0.5 mg, droperidol 5 mg, dissolved in 0.9% sodium chloride injection 100 ml for postoperative analgesia, while compound salvia miltiorrhiza injection 4 mg was added in the combi- nation group. VAS and Ramsay score were observed before operation and at 4,8,24 and 72 h after operation in the two groups, as well as the expressions of COX-1, COX-2, IL-1β and TNF-α before operation and at 48 h after operation. Results The VAS and Ramsay scores were significantly decreased in the two groups after treatment, which were significantly better in the combination group than those in the single group （P〈 0.05）. The numbers of patients whose VAS and Ramsay scores were from 0 to 3 and 0 to 1 respectively showed in- creasing trends at 4,8,24,72h after operation, and which were higher in the combination group than those in the single group（P 〈 0.05 ）. The expressions of COX-1, COX-2, IL-1, TNF-α were significantly decreased in the two groups after treatment, which were more decreased in the combination group than those in the single group（P〈 0.05）. Conclusion Compound salvia mihiorrhiza injection and fentanyl combined with lappacon- itine is a safe and effective postoperative analgesia method in patients after radical resection for rectal cancer.