摘要
目的:对比芬太尼静脉自控镇痛模式与硬膜外联合蛛网膜下腔阻滞镇痛模式应用于下肢骨折术后的镇痛效果及对炎性、免疫功能的影响。方法:选取2018年8月至2020年2月于梧州市中医医院接受治疗的101例下肢骨折手术患者为研究对象,以随机数字表法分为两组,甲组行芬太尼静脉自控镇痛(单一镇痛模式),乙组行硬膜外联合蛛网膜下腔阻滞镇痛(多模式镇痛),对比两组术后不同时间点的视觉模拟疼痛(Visual analogue pain score,VAS)评分、手术前后免疫功能指标(CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+))、炎性因子[白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]变化情况。结果:与甲组比较,乙组术后12h、术后24h与术后48h时VAS评分均更低(P<0.05);术后24h、48h时,乙组CD4^(+)、CD4^(+)/CD8^(+)均高于甲组(P<0.05);术后24h、48h时,乙组IL-6、TNF-α浓度均低于甲组(P<0.05)。结论:硬膜外联合蛛网膜下腔阻滞镇痛模式应用于下肢骨折术后的镇痛效果理想,优于芬太尼静脉自控单一镇痛模式,且能改善机体炎症因子水平与免疫功能。
Objective:To compare the analgesic effect of Fentanyl intravenous controlled analgesia mode and epidural combined subarachnoid block analgesia mode in the postoperative treatment of lower limb fractures and its effects on inflammatory and immune function.Methods:A total of 101 patients with lower limb fracture surgery who received treatment in Wuzhou Hospital of Traditional Chinese Medicine from August 2018 to February 2020 were selected as the research objects.They were divided into two groups by random number table method.Group A received Fentanyl intravenous controlled analgesia(single analgesia mode),group B received epidural combined subarachnoid block analgesia(multi-mode analgesia).Visual analog pain score(VAS),immune function indexes(CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)),inflammatory factor[interleukin-6(IL-6),tumor necrosis factor-α,(TNF-α)were compared between the two groups at different time points after operation.Results:Compared with group A,VAS scores in group B were lower at 12 h,24 h and 48 h after operation(P<0.05);CD4^(+),CD4^(+)/CD8^(+)in group B were higher than those in group A at 24 h and 48 h after operation(P<0.05);The concentrations of IL-6 and TNF-α in group B were lower than those in group A at 24 h and 48 h after operation(P<0.05).Conclusion:Epidural combined subarachnoid block analgesia mode has ideal analgesic effect after lower limb fracture surgery,which is superior to Fentanyl intravenous controlled single analgesia mode,and can improve the level of inflammatory factors and immune function.
出处
《大众科技》
2021年第11期57-60,共4页
Popular Science & Technology
关键词
芬太尼
静脉自控镇痛
硬膜外
蛛网膜下腔阻滞
下肢骨折术
镇痛效果
炎性
免疫功能
Fentanyl
intravenous controlled analgesia
epidural
subarachnoid block
lower limb fracture
analgesic effect
inflammatory
immune function
