盐酸羟考酮超前镇痛对腹部闭合性损伤患者血流动力学及炎症反应的影响

Effects of preemptive analgesia with oxycodone hydrochloride on hemodynamics and inflammatory response in patients with closed abdominal injury

目的探讨盐酸羟考酮超前镇痛对腹部闭合性损伤患者血流动力学及炎症反应的调节效果。方法回顾性分析2016年7月至2018年10月治疗的102例腹部闭合性损伤患者的临床资料,依据超前镇痛药物的不同,将上述入选者进一步分为对照组(0.9%氯化钠溶液,51例)与观察组(盐酸羟考酮,51例),比较两组患者血流动力学[平均动脉压(mean artery pressure,MAP)与心率(heart rate,HR)]、炎症反应[白细胞介素-6(interleukin 6,IL-6)与肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)]与镇痛效果。结果术前、拔管时与拔管后30 min,两组患者MAP与HR比较差异均无统计学意义(均P>0.05);术后1 d,观察组IL-6与TNF-α水平均低于对照组,差异均有统计学意义(均P<0.05);术后1 d,两组视觉模拟评分法(VAS)评分比较差异无统计学意义(P>0.05);术毕苏醒即刻、术后2 h、6 h与12 h观察组VAS评分均低于对照组,差异均有统计学意义(均P<0.05)。结论腹部闭合性损伤患者通过盐酸羟考酮超前镇痛,可有效维持血流动力学稳定,且炎症反应相对较轻,镇痛效果良好。

Objective To investigate the effect of preemptive analgesia with oxycodone hydrochloride on hemodynamics and inflammatory response in patients with closed abdominal injury.Methods The clinical data of 102 patients with closed abdominal injury treated in our hospital from July 2016 to October 2018 were retrospectively analyzed.According to the different preemptive analgesic drugs,the selected subjects were further divided into control group(0.9%NaCl solution,n=51)and observation group(oxycodone hydrochloride,n=51).The hemodynamics[mean arterial pressure(MAP)and heart rate(HR)],inflammatory reaction[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],and analgesic effect were compared between the two groups.Results Before operation,immediately and 30 minutes after extubation,there were no statistically significant differences in MAP or HR between the two groups(all P>0.05).On the 1st day after operation,the levels of IL-6 and TNF-αin the observation group were lower than those in the control group(all P<0.05).On the 1st day after operation,there was no statistically significant difference in VAS score between the two groups(P>0.05);immediately,2 h,6 h,and 12 h after operation,the scores of VAS in the observation group were lower than those in the control group(all P<0.05).Conclusion The preemptive analgesia with oxycodone hydrochloride in patients with closed abdominal injury can effectively maintain the hemodynamic stability,and the inflammatory reaction is relatively mild and the analgesic effect is good.