帕瑞昔布钠对直肠癌患者肾功能和术后镇痛舒芬太尼消耗量的影响

为探讨帕瑞昔布钠短期应用对直肠癌患者术后镇痛和肾功能的影响，本研究选取150例择期直肠癌根治术患者（ASAⅠ～Ⅲ级）随机分为三组，即帕瑞昔布钠组（A组）、帕瑞昔布钠复合病人自控静脉镇痛（PCIA）组（B组）和安慰剂复合PCIA组（C组）。对比分析各组术前、静注帕瑞昔布钠前即刻及静注帕瑞昔布钠后1h、2h、6h、12h、24h、36h和48h的血肌酐和血尿素氮含量；采用视觉模拟评分（VAS）法测定静注帕瑞昔布钠后1h、2h、6h、12h、24h、36h和48h时的疼痛程度；记录各相邻时间点之间舒芬太尼的消耗量。结果显示，三组患者血肌酐、血尿素氮含量组间和组内差异均无统计学意义，P〉0．05；与C组比较，A组患者静注帕瑞昔布钠后1h、2h、6h和12h VAS评分升高，B组患者静注帕瑞昔布钠后1h、2h和6h VAS评分降低，B组患者静注帕瑞昔布钠后1h、2h、6h、12h、24h和36h舒芬太尼各时段消耗量减少。结果表明，短期、少量使用帕瑞昔布钠对肾功能正常的直肠癌患者的肾功能无影响。术后PCIA复合应用帕瑞昔布钠使镇痛更完善，并可减少舒芬太尼术后镇痛消耗量。

Impact of Parecoxib Sodium on the Kidney Function of Rectal Cancer Patient and Consumption of Sufentanil for Postoperative Analgesia

The objective of this study was to explore the influence of short-term using parecoxib sodium （PS） on postoperative analgesia and kidney function of rectal cancer patient. This study recruited 150 patients to be subjected to schedule radical operation for their rectal cancer（ASA Ⅰ～Ⅲ stage） and divided them randomly into three groups：A, B and C group, which was respectively subjected to PS, PSq-PCIA（patient-controlled intravenous analgesia） and placebo＋PCIA; the levels of serum inosine and urea nitrogen before operation,just the time point before intravenous injection of PS, and at 1,2,6,12,24,36 and 48h after the injection of PS were compared and analysed, by using VAS method the pain extent at 1,2,6,12,24, 36 and 48h after the injection of PS were measured, and the consumption of sufentanil between each two neighbour time point were recorded. As results,among the 3 groups in serum inosine and urea nitrogen the inter-and intra-groups differences did not any have statistical significance （ P 〉 0.05） ; compared with C group,the VAS rating of A group at 1,2,5 and 12h after iniection of PS increased,that of B group at 1,2 and 6h after injection of PS decreased,the sufentanil consumption of B group at 1,2,6,12,24 and 36h reduced. Results show that short-term and less using parecoxib sodium has not any influence on the kidney function of rectal cancer patients whose kidney function are normal originally;PCIA＋PS can make analgesia to become more perfect,and reduce the consumption of sufentanil for postoperative analgesia.