氯诺昔康超前镇痛对胃癌患者术后血浆皮质醇浓度的影响

目的：观察非甾体消炎镇痛药氯诺昔康超前镇痛对胃癌患者术后血浆皮质醇浓度的影响。方法：Ⅰ组15例术前给予氯诺昔康8mg，手术后经PCA泵以氯诺昔康和吗啡镇痛；Ⅱ组15例仅在术后经PCA泵给予吗啡镇痛。分别于术前、术毕、术后24h、术后72h抽取外周血，测定血浆皮质醇（Cor）浓度。结果：两组患者术后VAS评分差异无统计学意义。与术前值比较，Ⅱ组患者术毕、术后24h时血浆皮质醇水平升高，Ⅰ组血浆皮质醇水平仅在术毕时高于术前（P〈0．05）。与Ⅱ组相比，Ⅰ组术毕、术后24h血浆皮质醇水平明显降低（P〈0．05）。结论：氯诺昔康超前镇痛能减轻皮质醇的增高程度，减轻胃癌患者术后的过度应激状态。

Influence of Preemptive Analgesia of Lornoxicam for Postoperative Plasma Cortisol Concentration of Patients with Gastric Cancer

Objective：To observe the influence of preemptive analgesia of lornoxicarn for postoperative plasma cortisol concentration of patients with gastric cancer. Methods： Ⅰ group： 15 cases received lornoxicam 8mg before operation and lornoxicam adding with morphine by PCA pump after operation in analgesis. Ⅱ group：15 cases received morphine only by PCA pump after operation in analgesis. Plasma cortisol concentration of peripheral blood was detected in 24h before,just and after operation and in 72 h after operation. Results： VAS grade had no difference after operation between the two groups. Comparing preoperanve value,the plasma cortisol concentration of patients in Ⅱ group rised in 24h just and after operation,and rised only just operation in Ⅰ group（P（0.05 ）. Comparing Ⅱ group, the plasma cortisol concentration was obvious lower in 24h just and after operation（P〈0.05）. Conclusions：Preemptive analgesia of lornoxicam can decrease higher level of cortisol and excessive stress state of patietns with gastric cancer after operation.