帕瑞昔布钠在老年结肠癌根治术前应用对术后疼痛与免疫水平的影响

Effect of parecoxib sodium on postoperative pain and immune level in elderly patients undergoing radical mastectomy

目的探讨帕瑞昔布钠在老年结肠癌根治术前应用对患者的疼痛与免疫指标的影响。方法采用随机数字表将我院拟实施结肠癌根治手术的老年患者118例分为超前镇痛组(麻醉诱导前30 min给予静脉注射帕瑞昔布钠40 mg)、常规组(给予等量0.9%氯化钠注射溶液)各59例,两组的麻醉方法一致,术后均采用静脉自控镇痛;对比两组患者手术时间、苏醒时间、拔管时间、镇痛泵按压次数、舒芬太尼用量、疼痛程度、躁动评分、T淋巴细胞水平。结果超前镇痛组的术后视觉模拟评分法(VAS)与常规组差异有统计学意义(P<0.05),在术后4 h、12 h及24 h均低于常规组;超前镇痛组的术后RAMSAY评分与常规组差异有统计学意义(P<0.05),在术后即刻、术后30 min及术后60 min均高于常规组;超前镇痛组的手术时间、苏醒时间、拔管时间与常规组比较,差异无统计学意义(P>0.05);超前镇痛组患者的镇痛泵按压次数、舒芬太尼用量均低于常规组(P<0.05);术前,超前镇痛组的CD3+、CD4+、CD8+、CD4+/CD8+与常规组差异无统计学意义(P>0.05);术后12 h、24 h,超前镇痛组患者的CD3+、CD4+/CD8+测定值高于常规组(P<0.05);超前镇痛组患者的不良反应发生率与常规组差异无统计学意义(P>0.05)。结论帕瑞昔布钠在老年结肠癌根治术前应用对于患者术后镇痛有一定的帮助,同时可以减轻术后镇痛舒芬太尼用量及手术对患者免疫水平的影响。

Objective To investigate the effects of parecoxib sodium on pain and immune parameters in patients with colon cancer before radical surgery.Methods A prospective randomized study was conducted to classify 118 elderly patients who underwent radical prostatectomy in our hospital into a pre-existing analgesia group(administered parecoxib sodium 40 mg 30 min before anesthesia induction)and the conventional group(administer the same amount of normal saline)There were 59 cases in each group.The anesthesia methods were the same in both groups.All patients underwent intravenous analgesia.The operation time,recovery time,extubation time,analgesic pump compression,sufentanil dosage,pain degree,Agitation score,T lymphocyte level.Results The postoperative VAS scores of the preemptive analgesia group were significantly different from those of the conventional group(P<0.05),and were lower than the conventional group at 4h,12h,and 24h after surgery.The postoperative RAMSAY score and the conventional group in the preemptive analgesia group.The difference was statistically significant(P<0.05).It was higher than the conventional group immediately after surgery,30 minutes after operation and 60 minutes after operation.The operation time,recovery time and extubation time of the advanced analgesia group were compared with the conventional group.There was no statistical significance(P>0.05).The number of analgesic pump presses and sufentanil in the patients with advanced analgesia were lower than those in the conventional group(P<0.05).Before surgery,CD3+,CD4+in the preemptive analgesia group,There was no significant difference between CD8+and CD4+/CD8+compared with the conventional group(P>0.05).At 12 h,24 h postoperatively,the CD3+and CD4+/CD8+values were higher in the patients with advanced analgesia than in the conventional group(P<0.05);There was no significant difference in the incidence of adverse reactions between the patients in the preemptive analgesia group and the conventional group(P>0.05).Conclusion The application of parecoxib sodium in the treatment of elderly colon cancer before surgery can help relieve postoperative analgesia of patients,and can reduce the effect of postoperative analgesic sufentanil and the impact of surgery on the patient's immune level.