腹腔镜下子宫全切术前应用帕瑞昔布钠的临床疗效

Clinical efficacy of parecoxib sodium before laparoscopic total hysterectomy

目的探讨腹腔镜下子宫全切术前应用帕瑞昔布钠的临床疗效。方法选取2020年4月至2021年4月于沈阳市妇婴医院拟行子宫全切术的88例患者作为研究对象,按照给药时机分为研究组(n=43)与对照组(n=45)。对照组于术毕前30 min静脉注射枸椽酸舒芬太尼和帕瑞昔布钠,研究组于术前30 min静脉注射帕瑞昔布钠,术毕前30 min静脉注射枸椽酸舒芬太尼,比较两组不同时间手术应激反应[白细胞介素-6(IL-6)、皮质醇(Cor)]、术后不同时间血清相关指标[微小RNA-150(miR-150)、微小RNA-155(miR-155)]及视觉模拟评分法(VAS)评分、不良反应发生情况。结果T1、T2时,两组IL-6、Cor水平均高于T0时,且T2时IL-6、Cor水平高于T1时,差异有统计学意义(P<0.05)。T0时,两组IL-6、Cor水平比较差异无统计学意义;T1、T2时,研究组IL-6、Cor水平均明显低于对照组,差异有统计学意义(P<0.05)。术后12 h,两组miR-150水平高于术后4 h,miR-155水平、VAS评分均低于术后4 h,差异有统计学意义(P<0.05);术后4、12 h,研究组miR-150水平高于对照组,miR-155水平、VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论腹腔镜下子宫全切术前应用帕瑞昔布钠镇痛可缓解术中应激反应,调节血清miRNA水平,减轻术后疼痛,且不增加不良反应发生风险,安全性较高。

Objective To investigate the clinical efficacy of parecoxib sodium before laparoscopic total hysterectomy.Methods 88 patients who underwent total hysterectomy in Shenyang Women's and Children's Hospital from April 2020 to April 2021 were selected as the research subjects,and they were divided into the study group(n=43)and the control group(n=45)according to the timing of administration.The control group was given sufentanil citrate and parecoxib sodium intravenously 30 min before the end of the operatio,the study group was given parecoxib sodium intravenously 30 min before the operation and sufentanil citrate intravenously 30 min before the end of the operation,the surgical stress response(interleukin-6[IL-6],cortisol[Cor]),serum related indicators(microRNA-150[miR-150],microRNA-155[miR-155])and visual analogue scale(VAS)scores at different time points after operation,and adverse reactions were compared between the two groups.Results At T1 and T2,the levels of IL-6 and Cor of the two groups were higher than those at T0,and the levels of IL-6 and Cor at T2 were higher than those at T1,the differences were statistically significant(P<0.05).At T0,there was no significant difference in the levels of IL-6 and Cor between the two groups;at T1 and T2,the levels of L-6 and Cor in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).At 12 h after operation,the levels of miR-150 of the two groups were higher than those at 4 h after operation,and the levels of miR-155 and VAS scores were lower than those at 4 h after operation,the differences were statistically significant(P<0.05);at 4 and 12 h after operation,the level of miR-150 in the study group was higher than that in the control group,and the level of miR-155 and VAS score were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The application of parecoxib sodium for analgesia before laparoscopic hysterectomy can relieve the stress reaction during operation,regulate the level of serum miRNA,and relieve the post-pain without increasing the risk of adverse reactions.