地塞米松对硬膜外麻醉后神经根损伤患者血清炎性因子及睡眠质量的影响

Effect of Dexamethasone on Serum Inflammatory Factors and Sleep Quality in Patients with Nerve Root Injury After Epidural Anesthesia

目的:探讨地塞米松对硬膜外麻醉后神经根损伤患者血清炎性因子及睡眠质量的影响。方法:本次研究选取我院收治90例行硬膜外麻醉穿刺时出现神经根损伤症状的患者,病例时间为2015年1月至2017年7月,将所有患者随机分为观察组(n=45)和对照组(n=45)。对照组术中及术毕给予0.9%氯化钠注射液(生理盐水)10 m L,观察组术中及术毕给予5 mg地塞米松加10 m L生理盐水治疗,比较2组患者术后的血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)以及白细胞介素1β(IL-1β)的浓度;统计并比较2组手术前后睡眠质量。结果:2组患者术后的血清TNF-α、IL-6及IL-1β浓度呈逐渐升高的趋势,观察组的上升幅度较小,对照组的上升幅度较大,其中观察组术后24 h、48 h、72 h的血清TNF-α、IL-6及IL-1β浓度均明显低于对照组(P<0.05,见表1);与术前相比,术后72 h 2组PSQI评分显著下降,且观察组显著高于对照组(P<0.05或P<0.01)。结论:地塞米松应用于硬膜外麻醉后神经根损伤患者中,能够减少炎性因子释放,改善神经根损伤症状及睡眠质量,临床效果显著,值得在临床推广应用。

Objective： To investigate the effect of dexamethasone on serum inflammatory factors and sleep quality in patients with nerve root injury after epidural anesthesia. Methods： This study selected our hospital 90 routine epidural puncture patients with symptoms of nerve root injury,for cases in time between January 2015 and July 2015,all of the patients were randomly divided into observation group（ n = 45） and the control group（ n = 45）. Control intraoperatie and never put off till tomorrow what you can give 0. 9% sodium chloride injection（ saline） 10 m L,intraoperative observation group and never put off till tomorrow what you can give 5 mg dexamethasone plus 10 m L saline treatment,compared two groups of patients with postoperative serum tumor necrosis factor alpha（ TNF alpha）,interleukin 6（ IL 6） and interleukin 1 beta（ IL-1 beta） concentration; To compare the quality of sleep before and after surgery. Results： two groups of patients with postoperative serum TNF alpha beta,IL-6 and IL-1 concentration was gradually rising trend,smaller rise of observation group,control group of rise is bigger,the observation group of 24 h,48 h,72 h after the serum TNF alpha beta,IL-6 and IL-1 concentrations were significantly lower than control group（ P〈0. 05,see table 1）. Compared with the preoperative period,PSQI score of 72 h 2 groups decreased significantly,and the observation group was significantly higher than the control group（ P〈0. 05 or P〈0. 01）. Conclusion： dexamethasone used in epidural anesthesia in patients with nerve root injury after,can reduce the release of inflammatory factors,improve the nerve root injury symptoms and sleep quality,clinical effect is remarkable,is worth popularizing in clinical application.