腹腔镜全子宫切除术后地佐辛联合布托啡诺镇痛镇静效果及对血清炎症指标的影响

Influences of dezosin combined with butorphanol for postoperative analgesic and sedate of patients after laparoscopic total hysterectomy on their serum inflammation indexes

目的:探究地佐辛联合布托啡诺在腹腔镜全子宫切除术后镇痛镇静效果及对患者血清高迁移率族蛋白-1(HMGB-1)、肿瘤坏死因子-α(TNF-α)和降钙素基因相关肽(CGRP)的影响。方法:选取2021年5月-2022年5月本院收治的80例接受腹腔镜全子宫切除术治疗的患者,按就诊顺序抽签随机分为对照组(n=40,地佐辛镇痛)观察组(n=40,布托啡诺联合地佐辛麻醉镇痛),比较两组术后镇痛、镇静评分、血清CGRP、TNF-α、HMGB-1水平、手术时间和呼吸恢复时间及不良反应。结果:观察组术后2、9、24h的镇痛及镇静评分均低于对照组,术后48h两组血清CGRP水平均降低且观察组(65.94±6.67 ng/L)低于对照组(72.18±6.86 ng/L),血清HMGB-1、TNF-α水平升高但观察组低于对照组,观察组呼吸恢复时间(39.6±6.3min)短于对照组(43.5±7.3min),不良反应发生率(22.5%)低于对照组(50.0%)(均P<0.05)。结论:地佐辛联合布托啡诺应用于腹腔镜全子宫切除术后,可减轻患者术后疼痛程度,减少患者疼痛应激反应,利于促进患者呼吸恢复,降低不良反应发生。

Objective:To explore the postoperative analgesic and sedate ffect of dezosin combined with butorphanol of patients after laparoscopic total hysterectomy,and to study their influences on the levels of serum high mobility group protein-l(HMGP-1),tumor necrosis factor-α(TNF-α),and calcitonin gene-related peptide(CGRP)of the patients.Methods:80 patients who wanted laparoscopic hysterectomy were selected and were randomly grouped into two groups(40 cases in each group)according to the treatment order from May 2021 to May 2022.The patients in the control group were treated with diazocin for analgesia,and the patients in the study group were treated with butorphanol com-bined with diazocin for analgesia.The scores of postoperative analgesia and sedation,the serum CGRP,TNF-a,HMGp-1 levels,the operation time,the respiratory recovery time,and the adverse reactions rate of the patients were compared between the two groups.Results:The scores of analgesia and sedation of the patients in the study group at 2h,9h,and 24h after surgery were significantly lower than those of the patients in the control group.The serum.CGRP level of the patients in both groups at 48h after surgery had decreased significantly,and which(65.94±6.67 ng/L)of the patients in the study group was significantly lower than that(72.18±6.86 ng/L)of the patients in the control group.The levels of serum HMGP-1 and TNF-aof the patients in both groups had increased significantly,and which of the patients in the study group were signifcantly lower than those of the patients in the control group.The respiratory recovery time(39.6±6.3min)of the patients in the study group was significantly shorter than that(43.5±7.3min)of the patients in the control group,and the incidence of adverse reactions(22.5%)of the patients in the study group was significantly lower than that(50.0%)of the patients in the control group(all P<0.05).Conclusion:Dezocine com-bined with butorphanol used after laparoscopic hysterectomy of the patients can reduce their degree of postoperative pain,reduce their pain stress reaction,promote their respiratory recovery,and reduce the incidence of their adverse re actions.