摘要
目的:研究地佐辛超前镇痛对进行选择性痔上黏膜切除钉合术患者术后血清炎症因子及疼痛介质的影响。方法:选取福建中医药大学附属人民医院2019年1月-2021年1月拟行选择性痔上黏膜切除钉合术患者,按随机数表法分为观察组(n=33)和对照组(n=32)。观察组切皮前10 min地佐辛0.1 mg/kg静脉注射,对照组注射等剂量生理盐水,两组采用喉罩全麻,行相同的麻醉诱导及麻醉维持。对比术前及术后2、6 h血清炎症因子指标[白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及疼痛介质指标[5-羟色胺(5-HT)和前列腺素E;(PGE;)]的变化。术后2、6 h分别采用Ramsay镇静评分(RSS)评价镇静效果,视觉模拟评分(VAS)评价镇痛效果。结果:术后2、6 h血清炎症因子指标IL-1β、IL-6和TNF-α较麻醉前升高,但观察组的水平低于对照组,差异均有统计学意义(P<0.05);血清疼痛介质指标5-HT和PGE;水平先升高后降低,观察组水平始终低于对照组,差异均有统计学意义(P<0.05);观察组术后2、6 h时RSS评分高于对照组,VAS低于对照组,差异均有统计学意义(P<0.05)。结论:地佐辛超前镇痛能够显著降低患者疼痛,抑制炎症反应,减少疼痛介质分泌,在选择性痔上黏膜切除钉合术术后镇痛有一定应用价值。
Objective:To study the effect of Dezocine preemptive analgesia on serum inflammatory factors and pain mediators after selective hemorrhoidectomy and stapling.Method:Patients who planned to undergo selective hemorrhoidectomy and stapling in the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2019 to January 2021 were selected,and divided into observation group(n=33)and control group(n=32)according to the random number table.The observation group was injected with 0.1 mg/kg Dezocine intravenously 10 minutes before skin incision,and the control group was injected with the same dose of normal saline.The two groups received laryngeal mask general anesthesia,and received the same induction and maintenance of anesthesia.The changes of serum inflammatory factors(IL-1β,IL-6,TNF-α),serum pain mediators(5-HT and PGE;)were compared before and after operation at 2 h and 6 h.Ramsay sedation scores(RSS)and visual analog scale(VAS)were used to evaluate the sedation and analgesic effect at 2 h and 6 h postoperatively.Result:2 h and 6 h after operation,serum inflammatory factors(IL-1β,IL-6 and TNF-α)increased,but the levels of observation group were lower than control group,the differences were statistically significant(P<0.05).The levels of serum pain mediators 5-HT and PGE;increased first and then decreased,and the levels of the observation group were always lower than the control group,the differences were statistically significant(P<0.05).And the RSS scores in the observation group were higher than those in the control group at 2 h and 6 h after operation,VAS score was lower than control group,the differences were statistically significant(P<0.05).Conclusion:Dezocine preemptive analgesia can significantly reduce pain,inhibit inflammatory reaction,reduce the secretion of pain mediators,and has a certain application value in selective hemorrhoidectomy and stapling.
作者
郑颖
ZHENG Ying(People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350000,China)
出处
《中外医学研究》
2022年第15期129-133,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
地佐辛
超前镇痛
选择性痔上黏膜切除钉合术
炎症因子
疼痛介质
Dezocine
Preemptive analgesia
Selective hemorrhoidectomy and stapling
Inflammatory factors
Pain mediator
