氟比洛芬酯注射液联合地佐辛注射液用于胃癌根治术患者镇痛的临床研究

Clinical trial of flurbiprofen axetil injection combined with dezocine injection on the analgesia of patients with radical gastrectomy

目的观察氟比洛芬酯注射液联合地佐辛注射液治疗胃癌根治术患者镇痛的临床疗效及安全性。方法将92例进行胃癌根治术的患者随机分为对照组和试验组,每组46例。对照组予以舒芬太尼5μg,静脉推注,手术结束前30min+2.5μg·kg^(-1)舒芬太尼,静脉输注,术后自控镇痛(PCA)持续48 h;试验组予以氟比洛芬酯50 mg和地佐辛5 mg,静脉推注,手术结束前30 min+氟比洛芬酯250 mg和地佐辛25 mg,静脉输注,术后PCA持续48 h。比较2组患者白细胞介素-2(IL-2)、IL-6、IL^(-1)0和β-淀粉样(Aβ)蛋白的表达,视觉模拟评分法(VAS)评分,躁动发生率,以及药物不良反应的发生情况。结果术后,试验组和对照组的躁动发生率分别为6.52%(3例/46例)和28.26%(13例/46例),差异有统计学意义(P<0.05)。术后第3天,试验组和对照组的IL-2分别为(37.68±4.45)和(30.69±4.31)pg·m L^(-1),IL-6分别为(12.96±1.89)和(18.99±2.53)ng·L^(-1),IL^(-1)0分别为(11.85±2.01)和(16.83±2.18)pg·m L^(-1),Aβ蛋白分别为(58.86±6.04)和(67.87±6.95)ng·L^(-1),VAS评分分别为(1.50±0.20)和(2.22±0.30)分,差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有恶心呕吐和嗜睡,对照组的药物不良反应主要有恶心呕吐、头晕头痛、嗜睡和皮肤瘙痒。试验组和对照组的总药物不良反应发生率分别为19.57%和28.26%,差异无统计学意义(P>0.05)。结论氟比洛芬酯注射液联合地佐辛注射液治疗胃癌根治术患者镇痛的临床疗效确切,其能有效调节血清IL-2、IL-6、IL^(-1)0和Aβ蛋白的表达,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of flurbiprofen axetil injection combined with dezocine injection on the analgesia of patients with radical gastrectomy. Methods A total of 92 patients with radical gastrectomy were randomly divided into control and treatment groups with 46 cases per group. Control group was given sufentanil 5 μg,intravenous injection, 30 min before the end of operation ＋ 2. 5μg·kg^（-1） sufentanil,intravenous infusion,postoperative patient controlled analgesia（ PCA） for 48 hours. Treatment group was given flurbiprofen 50 mg and dezocine 5 mg,intravenous injection,30 min before the end of operation ＋ flurbiprofen 250 mg and 25 mg dezocine,intravenous infusion, postoperation PCA for 48 hours. The expressions ofinterleukin-2（ IL-2）,IL-6,IL^（-1）0 and β-amyloid（ Aβ） protein,the scores of visual analogue scale（ VAS）,restlessness rate,and adverse drug reactions were compared between two groups. Results After operation,the restlessness rates of treatment and control groups were 6. 52%（ 3 cases/46 cases） and 28. 26%（ 13 cases/46 cases） with significant difference（ P〈0. 05）. 3 days after operation,the main indexes of treatment and control groups were compared： IL-2 were（ 37. 68 ± 4. 45） and（ 30. 69 ± 4. 31） pg · m L^（-1）,IL-6 were（ 12. 96 ± 1. 89） and（ 18. 99 ± 2. 53） ng · L^（-1）,Aβ protein were（ 58. 86 ± 6. 04） and（ 67. 87 ± 6. 95） ng · L^（-1）,VAS scores were（ 1. 50 ± 0. 20） and（ 2. 22 ± 0. 30）,the differences were statistically significant（ all P〈0. 05）. The main adverse drug reactions of treatment group were nausea,vomiting and lethargy,which in the control group were nausea and vomiting,dizziness and headache,drowsiness and pruritus. The total incidences of adverse drug reactions in treatment and control groups were 19. 57% and 28. 26% without significant difference（ P〉0. 05）. Conclusion Flurbiprofen axetil injection combined with dezocine injection has a definitive clinical efficacy on the analgesia of patients with radical gastrectomy,which can significantly regulate the expressions of serum IL-2,IL-6,IL^（-1）0 and A β protein,without increasing the incidence of adverse drug reactions.