地佐辛联合舒芬太尼静脉自控镇痛对肝癌射频消融术后患者疼痛及炎症反应的影响

Effect of Patient-controlled Intravenous Analgesia with Dezocine Combined with Sufentanil on Pain and Inflammatory Response in Patients after Radiofrequency Ablation for Liver Cancer

目的 :观察地佐辛联合舒芬太尼对肝癌射频消融术后患者疼痛及炎症反应的影响。方法 :选取2015年12月—2017年5月我院普外科收治的行射频消融术的肝癌患者60例,按随机数字表法分为观察组与对照组,各30例。观察组给予地佐辛联合舒芬太尼进行术后静脉自控镇痛(patientcontrolled intravenous analgesia,PCIA),对照组仅采用舒芬太尼进行PCIA。比较两组视觉模拟评分(visual analogscale,VAS评分)、数字镇静评分(numeric sedation scale,NSS);镇痛泵有效按压次数;各时间段血浆中白细胞介素(interleukin,IL)-2、IL-6以及肿瘤坏死因子(TNF)-α含量;术后不良反应的发生率。结果 :术后各时间点观察组VAS评分均低于对照组,差异有统计学意义(P <0.01);术后各时间段两组NSS评分比较差异无统计学意义(P> 0.05);术后48小时内两组镇痛泵有效按压次数比较差异无统计学意义(P> 0.05);T2、T3时间段观察组IL-6、TNF-α含量均低于对照组,IL-2含量均高于对照组,差异有统计学意义(P <0.05);观察组恶心呕吐、头晕嗜睡发生率低于对照组,差异有统计学意义(P <0.05)。结论 :地佐辛联合舒芬太尼治疗肝癌射频消融术的术后静脉自控镇痛效果较好,能够减轻患者术后的炎症反应,有利于患者康复,且安全性高。

Objective:To observe the effect of dezocine combined with sufentanil on pain and inflammatory response in patients after radiofrequency ablation for liver cancer.Methods:60 patients with liver cancer who underwent radiofrequency ablation in our hospital from December 2015 to May 2017 were randomly divided into an observation group and a control group,30 cases each.The patients in the observation group were given dezocine combined with sufentanil for postoperative patient-controlled intravenous analgesia(PCIA),and the patients in the control group were only given sufentanil for PCIA.The scores of visual analogue scale(VAS)and numerical sedation scale(NSS),the number of effective pressing of analgesic pumps,the plasma levels of interleukin(IL)-2,IL-6 and tumor necrosis factor-α(TNF)-αin each period and the incidence of adverse reactions after operation were compared between the two groups.Results:The VAS scores in the observation group were lower than those in the control group at each time point after surgery,with statistically significant differences(P<0.01).There was no statistically significant difference in the NSS scores at each time point between the two groups(P>0.05).There was no statistically significant difference in effective pressing times of analgesic pumps within 48 hours after operation between the two groups(P>0.05).The levels of IL-6 and TNF-αin the observation group were lower than those in the control group at the time points of T2 and T3,while the level of IL-2 was higher than that in the control group,with statistically significant differences(P<0.05).The incidences of nausea,vomiting,dizziness and drowsiness in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:Dezocine combined with sufentanil has a good effect on patient-controlled intravenous analgesia after radiofrequency ablation for liver cancer,which can alleviate inflammatory response in the patients,and is conducive to the rehabilitation of patients,and has high safety.