帕瑞昔布钠超前镇痛对食管癌患者术后近期治疗效果的影响

Effect of preemptive analgesia with pericoxib sodium on postoperative short-term efficacy in patients with esophageal cancer

目的探讨帕瑞昔布钠超前镇痛对食管癌患者术后躁动、炎症反应和应激反应的影响。方法选取2015年1月至2019年2月间陕西省康复医院收治的113例原发性食管癌患者,根据镇痛方案不同分组,采用常规镇痛治疗的60例患者纳入对照组,采用帕瑞昔布钠超前镇痛治疗的53例患者纳入研究组。比较两组患者术后躁动发生情况及术前、术后30min和术后60min时血清中炎症因子和应激激素含量的差异。结果研究组患者苏醒期镇静-躁动评分(SAS评分)值及躁动发生率均低于对照组患者,差异均有统计学意义(均P<0.05)。术前,两组患者血清中炎症因子白介素-1β(IL-1β)、肿瘤坏死因子α(TNF-α)和血管细胞黏附分子-1(VCAM-1)含量比较,差异无统计学意义(P>0.05)。术后30min和术后60min,两组患者血清中IL-1β、TNF-α和VCAM-1的含量均高于术前,且研究组患者IL-1β、TNF-α和VCAM-1的含量均低于对照组相应时间点,差异均有统计学意义(均P<0.05)。术前,两组患者血清中应激激素血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)和皮质醇(Cor)含量比较,差异无统计学意义(P>0.05)。术后30min和术后60min,两组患者血清中AngⅡ、NE和Cor的含量均高于术前,且研究组患者血清中AngⅡ、NE和Cor的含量均低于对照组相应时间点,差异均有统计学意义(均P<0.05)。结论食管癌患者接受帕瑞昔布钠超前镇痛,可有效减少术后躁动发生并抑制全身炎症反应及应激反应。

Objective To explore the efficacy of preemptive analgesia with pericoxib sodium on postoperative short-term efficacy in patients with esophageal cancer.Methods One hundred and thirteen patients with primary esophageal cancer who underwent surgical treatment at Shaanxi Rehabilitation Hospital and Baoji Central Hospital between January 2015 and February 2019 were selected as research subjects.They were divided into a study group(53 patients)and a control group(60 patients).The study group was given preemptive analgesia with pericoxib sodium and the control group was given routine analgesia.The incidence of agitation was compared between the two groups after the operation.The differences in the incidence of postoperative,serum inflammatory factors and stress hormones were also compared between two groups before the operation,and at 30 min and 60 min after the surgery.Results The analgesia-agitation scores(SAS score)and the incidence of agitation during waking hours were lower in study group than in the control group(all P<0.05).There was no significant difference in the incidence of Interleukin 1β(IL-1β),tumor necrosis factor-α(TNF-α)and vascular cell adhesion molecule-1(VCAM-1)between the two groups(P>0.05).At 30 min and 60 min after the operation,IL-1β,TNF-αand VCAM-1 levels were higher than before the operation with the study group lower than the control group(all P<0.05).Befeore the operation,there was no significant difference in the levels of angiotensinⅡ(AngⅡ),norepinephrine(NE)and cortisol(Cor)(P>0.05).At 30 min and 60 min after the operation,AngⅡ,NE and Cor levels were higher than before the operation with the study group lower than the control group(all P<0.05).Conclusion Parecoxib analgesia with pericoxib sodium can effectively reduce postoperative agitation,inhibit systemic inflammatory response and stress reaction in patients with esophageal cancer.