氟比洛芬酯超前镇痛对腭咽成形术后疼痛及炎性因子水平的影响

The influence of Flurbiprofen axetil preemptive analgesia on pain and inflammatory factors after palatopharyngoplasty

目的探讨氟比洛芬酯超前镇痛对腭咽成形术后疼痛及炎性因子水平的影响。方法选取本院2014年11月至2016年11月就诊的阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome,OSAHS)患者60例为研究对象,采用随机数表法将其分为观察组与对照组,每组各30例。观察组患者在麻醉诱导前10分钟和手术结束前给予氟比洛芬酯50 mg静脉注射,对照组患者同期不予任何干预措施。两组患者均行气管插管静脉-吸入复合麻醉,麻醉诱导相同。观察并比较两组患者住院天数,不良反应发生率,术后1、6、12、24小时视觉模拟评分法(visual analogue scale,VAS)评分,术前、术后即刻、术后6小时及24小时静脉血白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及血小板聚集率。结果观察组患者住院天数显著短于对照组(P<0.05),术后1、6、12、24小时VAS评分均显著低于同时间点对照组(P<0.05)。术后即刻、术后6小时及术后24小时,两组患者IL-6和TNF-α水平均显著高于术前(P<0.05),但观察组患者IL-6和TNF-α水平均显著低于同时间点对照组(P<0.05)。术后即刻、术后6小时及术后24小时,两组患者血小板1分钟聚集率、5分钟聚集率及最大聚集率比较差异均无显著性(P>0.05)。观察组患者不良反应发生率显著低于对照组(P<0.05)。结论氟比洛芬酯用于腭咽成形术超前镇痛效果明显,且不良反应少,能明显抑制术后炎性反应发生,同时对血小板聚集率无明显影响。

Objective To investigate the influence of Flurbiprofen preemptive analgesia on pain and inflammatory factors after palatopharyngoplasty. Method 60 patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） were selected from November 2014 to November 2016 in our hospital. They were randomly divided into observation group and control group, 30 cases in each group. Observation group patients were given intravenous injection of 50 mg Flurbiprofen at anesthesia induction and 10 min before the end of surgery, while control group patients were given no intervention. Two groups patients were given endotracheal intubation inhalation anesthesia, the same anesthesia induction. The hospital day, adverse reactions, visual analogue scale （VAS） scores at 1h, 6h, 12h, 24h after operation, the levels of interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α） and platelet aggregation rate before operation, immediately after operation, postoperative 6h and 24h were detected. Result The hospital day of observation group was significantly less than that of control group （P〈0.05）. VAS scores at 1h, 6h, 12h and 24h after operation of the observation group were significantly lower than those of control group （P〈0.05）. Compared with before operation, the levels of IL-6, TNF-α immediately after operation, postoperative 6h and 24h of the two groups significantly increased （P〈0.05）, but the levels of IL-6, TNF-α of observation group were significantly lower than those of control group at the same time （P〈0.05）. The platelet aggregation rate of 1 min, 5 min and the maximum in the two groups showed no significant differences immediately after operation, postoperative 6h and 24h （P〉0.05）. The adverse reactions rate of observation group was significantly lower than that of control group （P〈0.05）. Conclusion Flurbiprofen preemptive analgesia analgesia has strong analgesic effect and less adverse reactions. It can significantly inhibit the inflammatory reaction after operation, and has little effect on the platelet aggregation rate.