早期规范化镇痛对重型多发伤患者应激反应的影响

目的探讨早期规范化镇痛治疗对重型多发伤患者创伤应激反应的影响。方法50例重型多发伤患者，随机分为芬太尼PCA组（patient controlled analgesia）和传统疼痛处理组，在受伤后3小时内开始实施镇痛，在入院即刻、24、48小时测定血清皮质醇、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平，对比分析其差异。结果两组基础值无显著差异，第24、48小时，芬太尼PCA组皮质醇、TNF-α、IL-6水平均显著低于传统疼痛处理组（P〈0．05）。结论与传统疼痛处理相比较，早期规范化镇痛治疗可显著减轻创伤后应激反应。

Influence of early analgesia by fentanyl on stress response of multiple trauma patients

Objective To evaluate the influence of early analgesia by fentanyl on stress response of multiple trauma patients. Methods Fifty cases with severe multiple trauma were randomly divided into 2 groups： fentanyl PCA group and traditional treatment group. Analgesia was performed within 3 hours after injury, and the blood samples were obtained to determine the serum level of cortisol,TNF-α,IL-6 at 0,24,48 hours after admission. Results The primary level of each item had no significant difference between 2 groups. The levels of eortisol ,TNF-α and IL- 6 at 24 and 48 hours in fentanyl PCA group were lower than those in traditional treatment group （ P 〈 0.05）. Conclusion Compared with traditional treatment group, early analgesia by fentanyl could repress the post-traumatic stress reaction.