氟比洛芬酯联合舒芬太尼术后镇痛对结肠癌根治术患者GPⅡb/Ⅲa、GMP-140表达的影响

目的:血小板在肿瘤细胞转移与血栓形成过程中发挥着重要作用,本研究拟观察氟比洛芬酯联合舒芬太尼术后镇痛对结肠癌根治术患者血小板GPⅡb/Ⅲa、GMP-140表达的影响.方法:40例全麻下接受结肠癌根治术的患者随机分为2组,每组20例:氟比洛芬酯联合舒芬太尼镇痛组(FS组);舒芬太尼镇痛组(S组).另选15例健康体检者作为正常对照组.采用视觉模拟评分法评价两组患者术后1,4,8,12,24和48 h镇痛的效果.采用流式细胞仪检测麻醉前(T_0)、手术开始后2h(T_1)、手术结束后4h(T_2)、手术结束后24 h(T_3)、手术结束后48 h(T_4)时GPⅡb/Ⅲa与GMP-140的表达.结果:两组患者术后镇痛效果无统计学差异(P＞0.05).与T0比较,FS组在T1时的GPⅡb/Ⅲa、GMP-140表达明显增加(P＜0.05);FS组在T_2、T_3、T_4时的GPⅡb/Ⅲa、GMP-140表达明显低于S组(P＜0.05);与T0比较,S组在T_1、T_2、T_3时的GPⅡb/Ⅲa和GMP-140表达明显增加(P＜0.05).结论:术后采用氟比洛芬酯联合舒芬太尼镇痛能有效减轻结肠癌根治术患者的术后疼痛及抑制血小板GPⅡb/Ⅲa复合物与GMP-140的过度表达.

EFFECT OF POSTOPERATIVE ANALGESIA WITH FLURBIPROFEN AXETIL COMBINED WITH SULFENTANIL ON PLATELET ACTIVATION IN PATIENTS WITH COLON CANCER

Objective:To explore the effect of postoperative analgesia with flurbiprofen axetil combined with sulfentanil on platelets activation in patients with colon cancer.Methods:Forty patients undergoing radical colon carcinoma operation were randomly divided into two groups(n=20).Flurbiprofen axetil combining sulfentanil group(FS)or sulfentanil alone group(S)were used for postoperative patient-controlled analgesia(PCA)respectively.The efficacy of analgesia was assessed by visual analogue scale (VAS)at 1,4,8,12,24 and 48 h after operation.The expression of GPⅡb/Ⅲa and GMP-140 were measured by flow cytometry before anesthesia,2 h after starting operation,4 h,24 h and 48 h after operation.Results:There was no significant difference in analgesic efficacy between two groups(P＞0.05).The expression of GPⅡb/Ⅲa and GMP-140 in group FS was increased significantly at 2 h after starting surgery as compared to the baseline values(P＜0.05).Compared with group S,the expression of GPⅡ b/Ⅲa and GMP-140 at 4 h,24 h and 48 h after operation was significantly lower in group FS(P＜0.05).The expression of GPⅡb/Ⅲa and GMP-140 in group S was increased significantly at 2 h after starting operation,4 h and 24 h after operation as compared to that at baseline value(P＜0.05).Conclusion:Flurbiprofen axetil combining sulfentanil for postoperative PCA can relief pain effectively and inhibit the excessive platelet activation of patients receiving radical colon carcinoma operation.