盐酸氢吗啡酮用于老年腹腔镜胆囊切除术效果评价

Evaluation of hydrochloric morphine hydrochloride in elderly patients undergoing laparoscopic cholecystectomy

目的研究探讨盐酸氢吗啡酮用于老年腹腔镜胆囊切除术中的临床效果。方法选择本院行腹腔镜胆囊切除术的100例老年患者(2016年1月-2018年6月),按照随机数字表法分为2组,50例/组,观察组给予盐酸氢吗啡酮,对照组给予等量安慰剂,比较手术时间、麻醉维持用药量、血流动力学指标、术后苏醒情况、术后不良反应发生率、术后疼痛评分、围手术期炎性因子指标。结果两组的手术时间、丙泊酚用量、瑞芬太尼用量比较,差异均无统计学意义(P> 0.05)。两组血压、心率在麻醉前后进行比较,差异均无统计学意义(P>0.05)。观察组的自主呼吸恢复时间、睁眼时间、拔管时间均短于对照组(P <0.05),其术后不良反应总发生率、术后疼痛评分均低于对照组(P <0.05)。切皮15min后、手术结束时,观察组的IL-1、IL-8、TNF-α水平均低于对照组(P <0.05)。结论盐酸氢吗啡酮应用于老年患者腹腔镜胆囊切除术中,可加快术后苏醒,减轻围手术期炎性反应,起到良好的镇痛作用。

Objective To investigate the clinical effect of hydromorphine hydrochloride in elderly patients undergoing laparoscopic cholecystectomy. Methods 100 elderly patients who underwent laparoscopic cholecystectomy in our hospital(January 2016 to June 2018)were selected and divided into two groups according to the random number table, 50 cases in each group. The observation group was given hydromorphone hydrochloride, and the control group was given the same amount of placebo. The operation time, anesthesia maintenance dosage, hemodynamic indexes, postoperative recovery, incidence of adverse reactions, postoperative pain score and perioperative inflammatory factors were compared. Results There was no significant difference in operation time, propofol dosage and remifentanil dosage between the two groups(P > 0.05). There was no significant difference in blood pressure and heart rate in the two groups before and after anesthesia(P > 0.05). The recovery time of spontaneous breathing, eye opening time and extubation time in the observation group were shorter than those in the control group(P < 0.05), the total incidence of adverse reactions and postoperative pain score in the observation group were lower than those in the control group(P < 0.05). After skin incision 15 minutes and at the end of operation, the levels of IL-1, IL-8 and TNF-alpha in the observation group were lower than those in the control group(P < 0.05).Conclusion Hydromorphone hydrochloride used in elderly patients undergoing laparoscopic cholecystectomy can accelerate postoperative recovery, reduce perioperative inflammatory reaction, play a good analgesic effect.