帕瑞昔布钠联合地佐辛对腹腔镜胃癌术后患者胃肠功能和镇痛效果的影响

Effect of parecoxib sodium combined with dezocine on gastrointestinal function and analgesia in patients after laparoscopic gastric cancer surgery

目的探讨帕瑞昔布钠联合地佐辛对腹腔镜胃癌术后患者胃肠功能和镇痛效果的影响。方法300例行腹腔镜手术的胃癌患者均分为对照1组、对照2组和联合组,对照1组予以帕瑞昔布钠镇痛,对照2组予以地佐辛镇痛,联合组予以帕瑞昔布钠联合地佐辛镇痛;比较3组患者术后不同时点胃肠运动功能(排气时间、排便时间、恢复进食时间)、痛觉过敏[疼痛视觉模拟(VAS)评分]及血清炎性因子[白细胞介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)]水平及术后不良反应(恶心呕吐、心率过快、头晕、高血压、皮肤瘙痒等)情况。结果3组患者性别、年龄、病程、手术时间及VAS评分比较,术前血清IL-6、IL-8、TNF-α水平比较,差异无统计学意义(P>0.05);术后联合组排气、排便时间、恢复进食时间均低于对照1组和对照2组,差异有统计学意义(P<0.05);术后2 h、6 h及12 h,3组患者VAS评分均较术前降低、术后12 h低于术后2 h和6 h,联合组低于对照1组及对照2组,差异有统计学意义(P<0.05);术后3组患者血清IL-6、IL-8、TNF-α水平较术前升高(P<0.05),但联合组低于对照1组和对照2组,差异有统计学意义(P<0.05);联合组总不良反应率低于对照1组(15.00%)和对照2组(17.00%),差异有统计学意义(P<0.05)。结论帕瑞昔布钠和地佐辛联合应用较单一应用帕瑞昔布钠或地佐辛更有利于胃癌腹腔镜术后患者胃肠运动功能恢复,降低痛觉过敏反应及炎性因子水平。

Objective To investigate the effect of parecoxib sodium combined with dezocine on gastrointestinal function and analgesia in patients after laparoscopic gastric cancer surgery.Methods A total of 300 gastric cancer patients who underwent laparoscopic surgery were divided into control group 1,control group 2,and combination group.For analgesia,control group 1 was given parecoxib sodium,and control group 2 was given dezocine,while combination group was given parecoxib sodium plus dezocine.Gastrointestinal function(exhaust time,defecation time,food intake time),hyperalgesia(visual analogue scale,VAS),serum inflammatory factors[interleukin-6(IL-6),IL-8,tumor necrosis factorα(TNF-α)]and postoperative adverse reactions(nausea and vomiting,tachycardia,dizziness,hypertension,skin itch,etc.)were compared among 3 groups at different time points after surgery.Results Before surgery,there were no significant differences in gender,age,course of disease,operation time,VAS score,serum levels of IL-6,IL-8,and TNF-αamong 3 groups(P>0.05).After surgery,exhaust time,defecation time,and food intake time in combination group were shorter than those in control group 1 and control group 2(P<0.05).VAS scores in 3 groups were lower at 2 h,6 h,and 12 h after surgery than before surgery,lower at 12 h after surgery than at 2 h and 6 h after surgery.VAS scores were less in combination group than control groups 1 and 2(P<0.05).The serum levels of IL-6,IL-8,and TNF-αin 3 groups were increased after surgery(P<0.05),but they were less in combination group than in control groups 1 and 2(P<0.05).The total adverse reaction rate of combination group was lower than that of control group 1(15.00%)and control group 2(17.00%,P<0.05).Conclusion Parecoxib sodium combined with dezocine is more beneficial to recovering gastrointestinal motility and reducing hyperalgesia and inflammatory factors in patients after laparoscopic gastric cancer surgery than the single use of parecoxib sodium or dezocine.