盐酸羟考酮注射液对腹腔镜下结肠癌根治术患者围术期应激因子的影响

The Effect of Oxycodone Hydrochloride Injection on Perioperative Stress Factors in Patients Underwent Laparoscopic Radical Resection of Colon Cancer

目的:探究盐酸羟考酮注射液用于经腹腔镜结肠癌根治手术围术期应激因子水平的影响。方法:选择在2016年1~12月我院行结肠癌根治手术的80例ASA评级为Ⅰ-Ⅱ级患者为研究对象,采用随机数字法分为盐酸羟考酮组和芬太尼组,每组各40例,比较两组患者围术期各时间点血流动力学变化及血浆中应激因子[急性期反应蛋白(CRP),皮质醇,肾上腺素、去甲肾上腺素]的浓度。结果:血流动力学方面,盐酸羟考酮组患者在T1、T2及T3的平均动脉压低于芬太尼组,差异有统计学意义(P<0.05);在T1及T2时盐酸羟考酮组患者与芬太尼组患者相比,前者心率平均水平要低,差异有统计学意义(P<0.05)。而在围术期应激因子方面,在T2及T3时,盐酸羟考酮组患者血浆中CRP、去甲肾上腺素及肾上腺素的浓度水平都较芬太尼组低,差异有统计学意义(P<0.05)。结论:应用盐酸羟考酮注射液全麻诱导的患者,诱导期的血流动力学参数更趋于稳定,应激因子水平也更低。而在诱导期后,盐酸羟考酮与芬太尼在维持血流动力学稳定及抗应激方面效果相当。

Objective: To explore the effect of oxycodone hydrochloride injection on perioperative stress factors in patients undergoing laparoscopic radical resection of colon cancer. Methods: Eighty American Society of Anesthesiologists( ASA) Class I or II adult patients scheduled to undergo laparoscopic radical resection of colon cancer from January to December in 2016 in our hospital were randomly allocated to two groups,oxycodone hydrochloride group( n = 40) and fentanyl group( n = 40). The hemodynamic changes and plasma concentrations of CRP,hydrocortisone,norepinephrine and epinephrine were compared between the two groups in our study. Results: Compared to fentanyl group,the mean arterial pressure of oxycodone hydrochloride group was lower at T1,T2 and T3( P < 0. 05). The heart rate in oxycodone hydrochloride group at T1 and T2 was lower,compared to fentanyl group( P < 0. 05). The plasma concentrations of CRP,norepinephrine and epinephrine,at T2 and T3,of oxycodone hydrochloride group were also lower than those of fentanyl group( P < 0. 05).Conclusion: Oxycodone hydrochloride injection helps to maintain hemodynamic stability and resist stress reaction in the period of anesthesia induction. After the induction,the effect of oxycodone hydrochloride injection and fentanyl in maintaining hemodynamic stability and resistance to stress reaction is almost the same.