氟比洛芬酯对妇科恶性肿瘤患者血清IL-6、IL-10水平影响

The Effect of flurbiprofen on serum IL-6,IL-10 in patients with gynecologic malignancy

目的探讨妇科恶性肿瘤患者应用氟比洛芬酯镇痛效果,血清白细胞介素-6(IL-6)、IL-10水平变化特点。方法选取2014年12月-2015年12月我院80例妇科恶性肿瘤患者,随机分为A、B组,每组40例,A组患者术后芬太尼常规镇痛,B组患者常规镇痛+氟比洛芬酯,记录不同时间点(T_0-T_4:术前、术后6、12、24、48h)Prince-Henry疼痛评分(PHS),IL-10、IL-6水平采用ELISA法测定,观察记录不良反应发生情况、胃肠功能恢复时间及机体凝血功能。结果术后芬太尼用量及PCA总按压次数A>B组(P<0.05),T_1、T_2时点PHS评分B组<A组(P<0.05),两组PHS评分T_3、T_4时点、不良反应发生率、凝血功能指标比较无统计学差异(P>0.05),凝血时间T_4>T_0(P<0.05),A、B组肠鸣音恢复时间分别为(43.88±11.21)h、(41.92±10.11)h,肛门排气时间分别为(48.66±11.24)h、(50.42±10.45)h(P>0.05),IL-6、IL-10水平T_1、T_2时>T0,IL-10水平T_1时A组<B组,IL-6水平T_1、T_2、T_3时A组>组(P<0.05)。结论氟比洛芬酯对妇科恶性肿瘤患者术后镇痛效果较好,可降低芬太尼用量及不良反应发生率,平衡血清炎性细胞因子水平,对胃肠功能及凝血功能恢复无影响。

Objective To explore the effect of flurbiprofen on postoperative analgesia and IL-6,IL-10 in patients with gynecologic malignancy. Methods A total of 80 patients undergoing routine gynecological malignancies from December 2014 to December 2015 were selected. They were randomly divided into group A and B（n=40）. Patients in group A were treated with fentanyl for conventional postoperative analgesia;patients in group B were given conventional analgesia combined with flurbiprofen. PrinceHenry pain score（PHS） at different time（T0-T4 before and 6,12,24,48 h after the operation） was recorded. IL-6,IL-10 levels were detected by ELISA assay. Adverse events,time to recovery of gastrointestinal function and blood coagulation function were observed. Results The dose of postoperative fentanyl and PCA press times in group B was significantly lower than that in group A（P〉0.05）. PHS at T1,T2 point in group A was higher than that in group B,PHS at T3,T4 point,the incidence of adverse reactions,and coagulation parameters in two groups had no difference（P〉0.05）. Coagulation time at T0 was shorter than T4（P〈0.05）. Group A,B recovery time of bowel sounds were（43.87±11.31）h,（41.94±10.21）h respectively,anal exhaust time were（48.64±11.22）h,（50.41±10.48）h（P 0.05）. Serum IL-6,IL-10 levels at T1,T2 were higher than T0,IL-10 levels at T1 in group A were lower than in group B（P〈0.05）. IL-6 levels at T1,T2,T3 in group A were higher than in group B（P〈0.05）,IL-6,IL-10 at the other point in two groups had no difference（P〉0.05）. Conclusion The results show that effect of flurbiprofen for postoperative analgesia in patients with gynecologic malignancies is better,it can lessen dosage of fentanyl and the incidence of adverse reactions,equilibrium serum inflammatory cytokines,and has no effect on recovery of coagulation and gastrointestinal function.