氟比洛芬酯镇痛对腹腔镜直肠癌根治术后患者炎性因子的影响

目的观察氟比洛芬酯镇痛对腹腔镜直肠癌根治术患者术后炎性因子及镇痛效果的影响。方法选择2012年6月至2013年3月山东省聊城市人民医院择期行腹腔镜直肠癌根治术患者80例，完全随机分为试验组和对照组，每组40例。试验组患者于手术前30 min静脉注射氟比洛芬酯50 mg（5 ml），对照组患者静脉注射0.9%氯化钠注射液5 ml。分别在用药前10 min及术后即刻、12 h、24 h采集静脉血，测定血浆P物质、白细胞介素6（IL 6）的浓度。采用视觉模拟评分（VAS）评价术后 2、6、12、24 h 的镇痛效果。结果2组术后即刻、12 h P物质浓度均高于本组基础值，差异均有统计学意义［对照组：（155±24）、（155±31）ng/L比（90±8）ng/L，试验组（105±13）、（111±12）ng/L比（92±10）ng/L，均P〈0.05］，术后24 h与本组基础值的差异无统计学意义（P〉0.05）。2组术后即刻、12 h、24 h IL 6浓度高于基础值，差异有统计学意义［对照组：（73±15）、（85±17）、（73±8）ng/L比（15±5）ng/L，试验组：（32±8）、（26±8）、（20±8）ng/L比（15±6）ng/L，均P〈0.05］。试验组术后即刻及术后12 h P物质浓度均低于对照组同时点，差异有统计学意义（P〈0.05）；2组术后24 h P物质浓度的差异无统计学意义（P〉0.05）。试验组血浆IL 6浓度在术后即刻、术后12 h和24 h均低于对照组，差异有统计学意义（P〈0.05）。试验组术后 2、12 h VAS评分均明显低于对照组［（2.1±0.6）分比（5.6±0.5）分，（1.9±0.9）分比（4.7±0.5）分，P〈0.05］，术后6 h VAS评分高于对照组［（2.4±0.5）分比（2.2±0.4）分］，差异均有统计学意义（均P〈0.05），2组术后24 h VAS评分差异无统计学意义（P〉0.05）。结论腹腔镜直肠癌根治术前给予氟比洛芬酯可降低炎性因子的产生，具有良好的镇痛效应。

Effect of flurbiprofen axetil on postoperative inflammatory factors and stress hormonein patients undergoing laparoscopic radical rectectomy for rectal cancer

ObjectiveTo investigate the effects of flurbiprofen axetil analgesia on inflammatory factors and postoperative analgesia in patients undergoing laparoscopic radical rectectomy for rectal cancer. MethodsEighty patients undergoing laparoscopic radical rectectomy for rectal cancer were randomly divided into 2 groups （n=40 in each）, flurbiprofen axetil group received intravenous flurbiprofen axetil 50mg/5 ml 30 minutes before anesthesia induction, and control group received normal saline 5 ml instead. Venous blood samples were obtained at 10 minutes before flurbiprofen axetil or normal saline was injected, mimediately when surgery was finished, 12 hours, and 24 hour safter the surgery w as finished, to determine the plasma levels of substance P and IL 6. At the same time, visual analogue scale（VAS） scores were recorded at 2, 6, 12 and 24 hours after the surgery. ResultsCompared to the control group, the plasma levels of substance P decreased in the flurbiprofen axetil group at immediately when surgery was finished and 12 hours [mimediately when surgery was finished：（105±13）ng/L vs （155±24）ng/L, 12 hours：（111±12）ng/L vs（155±31）ng/L, 10 minutes：（92±10）ng/L vs（90±8）ng/L,P〈0.05]. The plasma levels of IL 6 decreased in the flurbiprofen axetil group at immediately when surgery was finished to 24 hours [mimediately when surgery was finished：（32±8）ng/L vs （73±15）ng/L, 12 hours：（26±8）ng/L vs （85±17）ng/L, 24 hours：（20±8）ng/L vs （73±8）ng/L,10 minutes：（15±6）ng/L vs （15±5）ng/L, P〈0.05]. VAS status had significant difference at 2, 6 and 12 hours postoperatively in the flurbiprofen axetil group compared to the control group [（2.1±0.6）scores vs （5.6±0.5）scores,（2.4±0.5）scores vs （2.2±0.4）scores,（1.9±0.9）scores vs （4.7±0.5）scores,P〈0.05]. Conclusionflurbiprofen axetil can reduce the production of in flammatory factors and produce better analgesia effect.