帕瑞昔布钠联合右美托咪定对甲状腺全麻手术患者炎性因子水平及应激反应的影响

Effects of parecoxib sodium combined with dexmedetomidine on inflammatory factors levels and stress response in patients undergoing thyroid general anesthesia surgery

目的探讨帕瑞昔布钠联合右美托咪定对甲状腺全麻手术患者炎性因子水平及应激反应的影响。方法选取2020年4月至2022年4月我院接受甲状腺全麻手术的88例患者作为研究对象,采用随机数字表法将其分为A组和B组,各44例。A组给予右美托咪定,B组给予帕瑞昔布钠联合右美托咪定。比较两组的麻醉效果。结果术前,两组的肿瘤坏死因子-α(TNF-α)、P物质(SP)及白细胞介素-6(IL-6)水平比较,差异无统计学意义(P>0.05);术后,B组的TNF-α、SP及IL-6水平均低于A组,差异具有统计学意义(P<0.05)。两组的去甲肾上腺素(NE)、肾上腺素(A)水平在麻醉诱导给药后5 min(T2)下降,插管前(T3)上升,插管后即刻(T4)又下降,B组的NE、A水平变化幅度小于A组。B组的不良反应总发生率为11.36%,显著低于A组的29.55%,差异具有统计学意义(P<0.05)。结论帕瑞昔布钠联合右美托咪定可有效抑制甲状腺全麻手术患者的炎性因子释放,减轻应激反应,且安全性较好。

Objective To investigate the effects of parecoxib sodium combined with dexmedetomidine on inflammatory factors levels and stress response in patients undergoing thyroid general anesthesia surgery.Methods A total of 88 patients who underwent thyroid general anesthesia surgery in our hospital from April 2020 to April 2022 were selected as the research objects.The patients were divided into group A and group B by random number table method,with 44 cases in each group.The group A was given dexmedetomidine,and the group B was given parecoxib sodium combined with dexmedetomidine.The anesthetic effects of the two groups were compared.Results Before operation,there were no significant differences in the levels of tumor necrosis factor-α(TNF-α),substance P(SP)and interleukin-6(IL-6)between the two groups(P>0.05);after operation,the levels of TNF-α,SP and IL-6 in the group B were lower than those in the group A,and the differences were statistically significant(P<0.05).The levels of norepinephrine(NE)and adrenaline(A)in the two groups decreased at 5 min after anesthesia induction(T2),increased before intubation(T3),and decreased immediately after intubation(T4),and the changes of NE and A levels in the group B were smaller than those in the group A.The total incidence of adverse reactions in the group B was 11.36%,which was significantly lower than 29.55%in the group A,and the difference was statistically significant(P<0.05).Conclusion Parecoxib sodium combined with dexmedetomidine can effectively inhibit the release of inflammatory factors in patients undergoing thyroid general anesthesia surgery,reduce stress response,and has good safety.