腹腔镜阑尾切除术前应用吲哚美辛栓和氯诺昔康疗效的比较

Comparison of the therapeutic effects of indomethacin suppository and lornoxicam application before laparoscopic appendectomy

目的比较腹腔镜阑尾切除术(LA)前应用吲哚美辛栓和氯诺昔康的镇痛、抗炎功能。方法收集2022年1月至4月首都医科大学附属北京潞河医院急诊全麻下行LA患者128例,采用随机数字表法分为2组,各64例,术前30 min给药,A组直肠予吲哚美辛栓100 mg,B组静脉滴注氯诺昔康8 mg。比较两组术后的镇痛效果、炎性指标、不良反应发生率等。结果A组术后0、3、6、12、18 h及出院前视觉模拟评分(VAS)(Z=-7.075、-5.455、-3.183、-3.378、-4.113、-4.941,均P<0.01)、术后24 h镇痛药使用量、术后VAS<2分时间、首次补救镇痛时间(Z=-6.005、-6.540、-6.041,均P<0.0001)均有改善。两组患者WBC、N%、L%、N/L、CRP、PCT、AIR评分、TNF-α、IL-6、IL-8、IL-10较术前的变化值差异无统计学意义。结论在LA术前应用吲哚美辛栓的镇痛效果优于氯诺昔康,可降低术后发热率,两者抗炎效果相似,未见明显不良反应,治疗效果显著。

Objective To compare the analgesic and anti-inflammatory functions of indomethacin suppository and lornoxicam application before laparoscopic appendectomy(LA).Methods One hundred and twenty-eight patients in the Affiliated Beijing Luhe Capital University of Medical Sciences from January to April 2022 were collected for LA with general anesthesia and divided into 2 groups(64 cases in each group)using the random number table method.The drug was administered 30 min before surgery,100 mg indomethacin suppository was given rectally in group A and 8 mg lornoxicam was administered intravenously in group B.The postoperative analgesic effect,inflammatory indexes,incidence of postoperative adverse effects were compared.Results Postoperative VAS score at 0,3,6,12,18 h(Z=-7.075,-5.455,-3.183,-3.378,-4.113,-4.941,all P<0.01),24 h postoperative analgesic use,time to postoperative VAS score less than 2,and time to first remedial analgesia(Z=-6.005,-6.540,-6.041,all P<0.0001)were all improved in group A.There were no statistically significant differences in the reduction of change values of WBC,N%,L%,N/L,CRP,PCT,AIR score,TNF-α,IL-6,IL-8,and IL-10 in both groups compared with those before surgery.Conclusion The analgesic effect of applying indomethacin suppository before LA is superior to that of lornoxicam,which can reduce the postoperative fever rate,the anti-inflammatory effect is similar,and no significant adverse effect is observed,with significant therapeutic effect.