羟考酮在肺切除围术期对炎症因子的影响研究

目的观察羟考酮注射液对肺叶切除术患者在围手术期对部分炎症因子的影响。方法选取40例常规肺叶切除术的患者,随机分为实验组(羟考酮组,A组,下同)和对照组(曲马多组,B组,下同)各20例。A组术后静脉泵注羟考酮(1 mg/ml,2 mg/h),B组术后静脉泵注曲马多(0.2 mg/kg/h);采集患者麻醉诱导前(T_0),术后4 h(T_1),术后8 h(T_2),术后24 h(T_3)动脉血标本,采用酶联免疫吸附法测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)的水平;并于T_0、T_1、T_2、T_3时间点记录患者生命体征(HR、MAP、RR、SPO_2),视觉模拟评分(VAS)。结果与T_0比较,两组TNF-α、IL-6、IL-10浓度在T1-3明显上升(P0.05),A组T_(1-3)血清TNF-α、IL-6浓度均明显低于B组(P0.05),而IL-10于T_1、T_3明显高于B组(P0.05),两组各时点VAS评分无显著差异(P0.05)。结论羟考酮注射液通过对血液中部分炎症因子的所起的作用,在一定程度上能减轻常规剖胸肺叶切除术术后的炎症反应,能较好地维持部分重要炎症因子的平衡,起到缓解术后免疫功能损伤的作用。

Effect of oxycodone on inflammatory factors in patients after pulmonary lobectomy

Objective To investigate the efficacy of oxycodone on partly inflammatory factors in patients af-ter pulmonary lobectomy. Methods 40 patients received pulmonary lobectomy were randomly divided into the oxyc-odone group (the group A, n=20) and the control group (the group B, n=20). The group A received oxycodone with 0. 9% sodium chloride continuous infusion (concentration 1 mg/ml, pace 2 mg/h), and the group B received tramadol with 0. 9% sodium chloride continuous infusion (pace 0. 2 mg·kg-1·h-1). The levels of TNF-α, IL-6 and IL-10 in plasma were measured immediately before induction of anesthesia ( T0 ) , 4 h ( T1 ) , 8 h ( T2 ) and 24 h ( T3 ) after operation in the two groups by using enzyme-linked immunosorbent. Their vital signs ( HR, MAP, RR, SPO2 ) and visual analogue scale ( VAS) scores were recorded at T0 ,T1 , T2 and T3 . Results The levels of TNF-α, IL-6 and IL-10 of the two groups at T1-3 increased significantly compared to T0 ( P<0. 05 ) . The levels of TNF-αand IL-6 at T1-3 were significantly lower in the group A than in the group B (P<0. 05), and the level of IL-10 was significantly higher in the group A than in the group B (P<0. 05) at T1 and T3. The VAS pain scores in the two groups had no significant difference (P>0. 05). Conclusion Oxycodone can partly relieve inflammatory reaction, well balance the inflammatory factors and alleviate postoperative immune injury in patients after pulmonary lobectomy, through influencing inflammatory factors in blood.