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注射用帕瑞昔布钠超前镇痛对开腹手术病人血清白介素-6的影响
引用本文:张莉莉,王虎山,姜长林,李晓梅,代春梅.注射用帕瑞昔布钠超前镇痛对开腹手术病人血清白介素-6的影响[J].按摩与导引,2010(3):6-7.
作者姓名:张莉莉  王虎山  姜长林  李晓梅  代春梅
作者单位:[1]吉林大学附属第一医院,长春130021 [2]黑龙江大庆油田总医院,大庆163001
摘    要:目的:本文旨在探讨在开腹手术中应用帕瑞昔布超前镇痛。测定血清IL--6的变化,以此探讨帕瑞昔布对开腹手术围术期致炎因子IL-6的影响。方法:选择胃癌病人30例,择期行胃癌根治术,随机分为两组:A组(实验组)和B组(对照组),两组均采用吸入麻醉,A组(实验组),术前30分钟静脉注射帕瑞昔布20mg,手术结束时静脉注射帕瑞昔布40mg,B组(对照组)不做任何处理。术后接PCA泵,芬太尼1mg+生理盐水至100ml,每小时2ml,负荷量0.5ml间隔15分钟。分别于入室后(T1),手术开始后3小时(T2),术后8小时(T3)和术后24小时(T4),四个时同点采取末梢静脉血3ml,用IL--6试剂盒采用放免法测定标本中血清IL--6的浓度。结果:A组T2,T3,T4时间点IL--6值与术前相比有显著差异P〈0.05。与B组相比差异有显著性。这说明帕瑞昔布超前镇痛对血清IL-6浓度的升高有-定程度的抑制作用。术后并发征发生率两组间差异显著。帕瑞昔布组显著降低阿片类药物相关不良反应发生率。结论:在开腹手术中,术前静脉给予帕瑞昔布超前镇痛,效果确切,降低了术后疼痛反应,抑制了围术期致炎因子IL-6的升高,对手术创伤后应激时细胞因子反应具有调控作用。

关 键 词:超前镇痛  选择性  COX2抑制剂  开腹手术  IL-6

The injection eases the pain in advance with the handkerchief auspicious past cloth sodium starts out from opposite directions folio the abdomen sur- gery patient blood to lie between purely the dement -- 6 influences
Institution:Zhang Lili Wang Hushan J iang Changlin et al
Abstract:Objeictive..This article is for the purpose of discussing in holds in the abdomen surgery to ease the pain in advance using the handkerchief auspi- cious past cloth. The determination blood serum IL-6 change, starts out from opposite directions folio the abdomen surgery by this discussion handkerohief aus- picious past cloth to encircle the technique time to send inflammation factor IL-- 6 the influence. Methods: Chooses the stomach cancer patient 30 examples,picks an auspicious date the good stomach cancer root governing skill, divides into two groups stochastically: A group (experimental group) and B group (control group) ,two groups use the inhalated narcosis, A group (experimental group), technique first 30 minute intravenous injection handkerchief auspicious past cloth 20mg, the surgery ended when the intravenous injection handkerchief auspicious past cloth 40m g, B group (control group) does not make any processing. After the technique meets the PCA pump,the fragrance too Nepal ling+ physiological saline to 100ml,each hour 2ml,load 0. 5ml is separated 15 minutes. In enters the inner rooms separately latter (T1) ,the surgery starts the latter 3 hours (T2) ,the technique latter 8 hours (T3) and the technique latter 24 hours (T4), four time spots adopt end venous blood 3ml,usea with the IL--6 reagent box puts exempts in the law determination specimen the blood serum IL--6 density. Results:A group of T2, T3, T4 time sdects in front of the IL--6 value and the technique compares has remarkable difference P〈0. 05. Compares the difference with B group to have the significance. This indicated the handkerchief auspicious past cloth eases the pain in advance to the blood serum IL--6 density aseerasion has certain degree inhibitory action. After the technique drafts the formation rate two groups of between differences to be remarkable concurrently. The hand- kerchief auspicious past cloth group obviously reduces the meconium class medicine correlation to respond the formation rate not good. Condesiens:In holds in the abdomen surgery, in front of the technique the vein gives the handkerchief auspicious past cloth to ease the pain in advance,the effect was accurate,after re- duces the technique the ache to respond,suppressed has encircled the technique time to send irfflammation factor IL--6 the ascension,alter surgery wound when stress the cell factor responded had the regulative function.
Keywords:Eases the pain The selective COX2 inhibitor To open abdomen surgery IL--6 in advance
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