氟比洛芬酯自控镇痛对妇科术后应激反应的影响

目的 观察应用氟比洛芬酯行患者自控静脉镇痛(PCIA)对妇科腹腔镜术后应激反应的影响.方法 择期行妇科腹腔镜手术患者120例,按随机数字表法分为氟比洛芬酯组和舒芬太尼组,每组各60例,术毕F组予氟比洛芬酯4mg/kg,S组予舒芬太尼1.5=μg/kg,分别用0.9%氯化钠稀释至150ml行PCIA.分别于术前、术毕、术后48h检测肿瘤坏死因子(TNF)-α及白细胞介素(IL)-6、IL-8、IL-10水平.结果两组术后疼痛视觉模拟评分(VAS)均小于4分,组间比较差异无统计学意义(P>0.05).两组患者组内和组间TNF-α比较差异均无统计学意义(P>0.05).两组术毕、术后48 hIL-6、IL-8均较术前明显升高(P<0.05),但氟比洛芬酯组[IL-6分别为(18.39±3.01)、(13.43±3.11)ng/L,IL-8分别为(24.25±2.75)、(15.31±2.65)ng/L]明显低于舒芬太尼组[IL-6分别为(38.02±2.95)、(23.28±2.43)ng/L,IL-8分别为(37.56±2.97)、(24.86±3.11)ng/L](P<0.05).两组术毕、术后48 h IL-10均较术前明显升高(P<0.05),但术后48 h氟比洛芬酯组[分别为(26.72±4.41)、(21.03±2.99)ng/L]明显高于舒芬太尼组[分别为(22.18±3.21)、(16.89±4.48)ng/L](P<0.05).结论 氟比洛芬酯用于妇科腹腔镜术后PCIA效果满意,能减轻术后应激反应.

Effects of the flurbiprofen axetil for postoperative patient-controlled intravenous analgesia on stress response after gynecological surgery

Objective To observe the effects of flurbiprofen axetil postoperative patient-controlled intravenous analgesia (PCIA) on stress response in patients undergoing gynecological laparoscopy operation.Methods One hundred and twenty ASA Ⅰ - Ⅱ gynecological laparoscopy operation patients were randomized to two groups, 60 cases in each group.Group F received flurbiprofen axetil 4 mg/kg while group S were given sufentanil 1.5μ g/kg for postoperative PCIA.Tumor necrosis factor-α (TNF-α ) and interleukin (IL)-6, IL-8, IL- 10 were estimated preoperative(T_0), operation termination(T_1) and 48 h after operation(T_2).Results VAS scores were less than 4 scores and no significant difference between two groups.There was no significant difference in TNF- α intraclass and interclass between two groups(P > 0.05 ).IL-6, IL-8, IL- 10 in two groups were significantly higher at T_1 and T_2 than those at To (P< 0.05).IL-6, IL-8 at T_1 and T_2 were lower in group F than those in group S [T_1 and T_2: IL-6 was ( 18.39 ± 3.01 ), ( 13.43 ± 3.11 ) ng/L, IL-8 was (24.25 ± 2.75 ), ( 15.31 ± 2.65 ) ng/L in group F; IL-6 was (38.02 ± 2.95 ), (23.28 ± 2.43 ) ng/L, IL-8 was ( 37.56 ± 2.97 ), ( 24.86 ± 3.11 ) ng/L in group S]( P < 0.05 ).While IL- 10 was significantly higher and lasted longer in group F than that in group S [(26.72±4.41), (21.03±2.99) ng/L in group F; (22.18 ± 3.21), (16.89 ± 4.48) ng/L in group S](P < 0.05).Conclusion PCIA with flurbiprofen axetil in gynecological laparoscopy operation patients can alleviate inflammatory response.