帕瑞昔布对胸腔镜肺叶切除术患者围术期镇痛效果、氧化应激反应及免疫功能的影响

Effect of parecoxib on perioperative analgesic effect,oxidative stress and immune function of patients undergoing thoracoscopic resection

目的探讨将帕瑞昔布应用于胸腔镜肺叶切除术的镇痛,观察其镇痛效果及对氧化应激反应和免疫功能的影响。方法将2015年2月至2017年5月我院收治的67例非小细胞肺癌(non small cell lung cancer,NSCLC)患者随机分为观察组和对照组,观察组术前15 min静脉注射帕瑞昔布30 mg(生理盐水稀释10 m L),对照组给予10 m L生理盐水,观察两组患者疼痛、氧化应激反应发生状况及对免疫功能的影响。结果给予帕瑞昔布超前镇痛后,观察组术后视觉模拟量表(Visual analogue scale,VAS)评分明显低于对照组(P<0.05);对照组术后氧化应激因子丙二醛(malondialdehyde,MDA)水平明显高于观察组(P<005);术后观察组血清超氧化物歧化酶(Superoxide dismutase,SOD)浓度高于对照组,差异显著(P<0.05);观察两组患者血清T细胞亚群,发现术后观察组患者血清CD_3^+、CD_4^+及NK水平明显高于对照组,差异显著(P<0.05);观察组患者血清CD_8^+水平明显低于对照组,差异显著(P<0.05)。结论应用帕瑞昔布超前镇痛后,可明显减轻患者疼痛,降低血清MDA水平,升高SOD水平,减少氧化应激反应发生,促进患者T细胞亚群趋于正常水平,提高机体免疫功能。

Objective To investigate the effect of parecoxib on perioperative analgesic effect,oxidative stress and immune function of patients undergoing thoracoscopic resection. Methods From February 2015 to May 2017,67 cases of non-small cell lung cancer（ NSCLC） were randomly divided into the observation group and the control group.The observation group was intravenously injected parecoxib 30 mg 15 min preoperatively（ diluted 10 m L with normal saline）,and the control group received 10 m L saline. Their pain,oxidative stress prevalence and impact on immune function were observed. Results Parecoxib preemptive analgesia,visual analogue scale（ VAS） score in the observation group was significantly lower than that in the control group（ P〈0. 05）. The level of oxidative stress factor malondialdehyde（ MDA） was significantly higher in the control group than in the observation group（ P〈0. 05）. The level of SOD was obviously higher in the observation group than in the control group（ P〈0. 05）. The levels of serum T cell subsets,postoperative serum CD_3~＋,CD_4~＋ and NK were significantly higher in the observation group than in the control group（ P〈0. 05）,and the level of serum CD_8~＋ was significantly lower in the observation group than in the control group（ P〈0. 05）. Conclusion The application of parecoxib preemptive analgesia can significantly reduce the pain of patients,decrease the level of MDA,increase the level of SOD,reduce oxidative stress,promote T cell subsets back to normal level,and improve their immune function.