氟比洛芬酯注射液用于消化道肿瘤切除手术的临床镇痛效果及对细胞因子表达的影响

Flurbiprofen Axetil Injection for Analgesia of Gastrointestinal Tumors and Its Effect on Cytokine Expression

目的研究消化道肿瘤切除手术患者中,氟比洛芬酯注射液的镇痛效果,以及其对细胞因子表达情况的影响。方法抽取92例消化道肿瘤切除术的住院患者,将其随机分为3组,分别为术前给药组(A)、术后给药组(B)、术后给予舒芬太尼组(即空白对照组:C)。A组患者在手术前给予静脉注射氟比洛芬酯注射液50 mg,B组患者在手术结束后进行静脉注射氟比洛芬酯注射液50 mg,C组则使用常规舒芬太尼自控静脉内镇痛泵。计算术后各组静息时视觉模拟评分(VAS),并对各组间评分进行比较。另外,采集麻醉前与手术切皮后6、12、24 h患者外周静脉血,测定其中血浆细胞因子白细胞介素-6(IL-6)和白细胞介素-10(IL-10),通过统计学方法对各组间的资料进行统计学分析。结果术后6 h时,C组患者VAS评分明显高于A组(P<0.05);术后12 h时,C组患者VAS评分明显高于A组和B组(均有P<0.05);术后48 h内,C组舒芬太尼总用量最多。3组患者术前血浆中IL-10和IL-6处于低水平表达状态,切皮后6 h,3组的IL-10明显升高,但C组低于A组和B组(均有P<0.05);且切皮后12 h,3组患者血浆IL-6含量达到最高值,且C组明显高于A组和B组(均有P<0.05);24 h时,C组患者的血浆IL-6含量仍高于A组。结论氟比洛芬酯注射液对消化道肿瘤手术患者有较好的镇痛效果,且术前给药效果更好,可以明显减少舒芬太尼的使用情况。另外,氟比洛芬酯注射液可以减少患者术后的炎症细胞因子IL-6的产生,增加抗炎症因子IL-10含量。

Objective To study the analgesic effect of flurbiprofen axetil injection and its influence on cytokine expression in patients underwent gastrointestinal tumor resection.Methods 92 cases inpatients underwent gastrointestinal tumor resection were selected and randomly divided into 3 groups,namely the preoperative administration group(A),the postoperative administration group(B),and the postoperative administration group.Compared with the mofetil group(ie blank control group:C);group A were given intravenous flurbiprofen axetil injection 50 mg before surgery,and group B were given intravenous flurbiprofen axetil injection 50 mg after the operation In group C,the conventional sufentanil self-controlled intravenous analgesia pump(PCIA)was used.The visual analogue scale(VAS)at rest of the 3 groups after the operation were calculated,and the scores between the groups were compared.In addition,the peripheral venous blood of patients before anesthesia and at 6,12,and 24 hours after surgical skin incision was collected,and the plasma cytokines interleukin-6(IL-6)and interleukin-10(IL-10)were determined by statistics.Statistical analysis of the data between each group.Results According to the inclusion criteria,a total of 92patients were enrolled and randomly divided into 3 groups,A,B,and C,with 34 patients in each group.There was no statistically significant difference in the basic data of the 3 groups of patients,and they were balanced and comparable.At 6h postoperatively,the score of group C was significantly higher than that of group A(P<0.05);at 12h postoperatively,the score of group C was significantly higher than that of groups A and B(both P<0.05);within 48h after surgery,The total amount of sufentanil in group C was the most,which was significantly higher than that in groups A and B.The levels of IL-10 and IL-6 in the plasma of the 3 groups of patients before the operation were at low levels.6 hours after the skin incision,the levels of IL-10 in the 3 groups were significantly increased,but group C was lower than group A and group B(both P<0.05).And 12h after skin incision,the plasma IL-6 content of the 3 groups reached the highest value,and the C group was significantly higher than the A and B groups(both P<0.05);at 24h,the plasma IL-6 content of the C group was still higher than group A.Conclusion Flurbiprofen axetil injection has a better analgesic effect on patients undergoing gastrointestinal tumor surgery,and the preoperative administration effect is better,which can significantly reduce the use of sufentanil.In addition,flurbiprofen axetil injection can reduce the production of inflammatory cytokine IL-6 in patients after surgery,and increase the content of anti-inflammatory factor IL-10.