摘要
目的探究纳布啡联合罗哌卡因腹横肌平面阻对腹腔镜子宫切除术患者术后镇痛及炎症因子的影响。方法选取2022年7月至2024年1月右江民族医学院附属医院收治的102例腹腔镜子宫切除术患者,以随机数字表法分为观察组、对照组各51例。2组患者均进行气管插管静脉全麻下腹腔镜子宫切除术治疗,对照组术后给于罗哌卡因腹横肌平面阻滞治疗,观察组术后采取纳布啡联合罗哌卡因腹横肌平面阻滞镇痛治疗。评估2组术后疼痛程度、应激反应指标、炎症因子、免疫功能、治疗安全性。结果观察组术后各时间点视觉模拟评分(VAS)低于对照组(P<0.05)。术后24 h,观察组患者活性氧(ROS)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)水平低于对照组(P<0.05)。术后24 h,观察组白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)水平均小于对照组(P<0.05)。术后24 h,CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。2组不良反应发生率分别为13.73%(7/51)、9.80%(5/51),差异无统计学意义(P>0.05)。结论纳布啡联合罗哌卡因腹横肌平面阻滞对腹腔镜子宫切除术患者术后镇痛效果良好,可降低应激反应,抑制炎症反应,减轻手术创伤对免疫功能的抑制作用,不良反应发生率较低。
Objective To investigate the effects of nalbuphine combined with ropivacaine on postoperative analgesia and inflammatory factors in patients undergoing laparoscopic hysterectomy.Methods A total of 102 patients undergoing laparoscopic hysterectomy,admitted to the Affiliated Hospital of Youjiang University of Ethnic Medicine from July 2022 to January 2024,were divided into an observation group and a control group(n=51 each).The control group received postoperative analgesia with ropivacaine,while the observation group received postoperative analgesia with nalbuphine combined with ropivacaine.The postoperative pain level,stress response indicators,inflammatory factors,immune function,and treatment safety of the two groups were evaluated.Results The observation group's VAS scores were significantly lower than those of the control group at 1,4,12,and 24 hours after surgery(P<0.05).At 24 hours after surgery,the observation group's levels of reactive oxygen species(ROS),adrenocorticotropic hormone(ACTH),and cortisol(Cor)were lower than those of the control group(P<0.05).The levels of interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),and tumor necrosis factor-alpha(TNF-α)in the observation group were also significantly lower than in the control group(P<0.05).Additionally,CD4^(+),CD3^(+),and CD4^(+)/CD8^(+)levels were higher in the observation group than in the control group,while CD8^(+)levels were lower(P<0.05).The incidence of adverse reactions in the observation group and control group was 13.73%(7/51)and 9.80%(5/51),respectively(P>0.05).Conclusion Nalbuphine combined with ropivacaine transverse plane block provides effective postoperative analgesia for patients undergoing laparoscopic hysterectomy,reduces stress response,inhibits inflammatory reactions,alleviates the suppression of immune function caused by surgical trauma,and has a low incidence of adverse reactions.
作者
黄娅婕
彭鸿浩
黎慧玲
覃英
HUANG Yajie;PENG Honghao;LI Huiling;QIN Ying(Department of Anesthesiology,Reproductive Hospital of Guangxi,Nanning,Guangxi 530029,China;Department of Andrology Laboratory,Reproductive Hospital of Guangxi,Nanning,Guangxi 530029,China;Youjiang University of Ethnic Medicine,Baise,Guangxi 533000,China;Department of Anesthesiology,Affiliated Hospital of Youjiang University of Ethnic Medicine,Baise,Guangxi 533000,China)
出处
《转化医学杂志》
2024年第5期792-796,共5页
Translational Medicine Journal
基金
广西医疗卫生适宜技术开发与推广应用项目(S2022137)
百色市科学研究与技术开发计划课题(百科20221411)。
