羟考酮与氢吗啡酮对腹腔镜胆囊切除术后疼痛及炎症细胞因子的影响

发布时间：2018-01-31 20:21

本文关键词： 羟考酮氢吗啡酮腹腔镜胆囊切除术镇痛细胞因子开腹手术　出处：《中国现代医学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的探讨羟考酮与氢吗啡酮对腹腔镜胆囊切除术后疼痛及炎症细胞因子的影响,为合理使用麻醉镇痛药,有效缓解术后疼痛及细胞因子失衡提供科学依据。方法选取拟行腹腔镜胆囊切除术患者40例,随机分为羟考酮组(A组)、氢吗啡酮组(B组),每组各20例。手术结束时,A组给予羟考酮0.1 mg/kg,B组给予氢吗啡酮2 mg,C组给予生理盐水2 ml。记录3组患者术后4、6、12和24 h的VAS评分,并在麻醉前和术后4、12和24 h检测血清IL-6和IL-10的水平。结果 A组与B组术后不同时间点VAS评分、Ramsay评分、血清IL-6、血清IL-10组内比较,差异有统计学意义(P0.05);A组与B组相比,VAS评分、Ramsay评分、血清IL-6、血清IL-10组内整体比较,差异无统计学意义(P0.05);麻醉后,A组与B组血流动力学指标比较,差异有统计学意义(P0.05),B组患者优于A组。结论羟考酮与氢吗啡酮各自均可有效缓解腹腔镜胆囊切除术患者的术后疼痛,同时能够调节促炎与抗炎细胞因子平衡,减弱炎症反应,促进术后康复。
[Abstract]:Objective to investigate the effects of hydroxycodone and hydromorphine on pain and inflammatory cytokines after laparoscopic cholecystectomy (LC). Methods Forty patients undergoing laparoscopic cholecystectomy were randomly divided into two groups: group A (hydroxycodone) and group B (hydromorphine). At the end of operation, group A was given hydrocodone 0.1 mg 路kg ~ (-1) 路kg ~ (-1) and group C was given 2 ml of normal saline after operation. The levels of serum IL-6 and IL-10 were measured at 12 and 24 hours before and after anesthesia. Results the VAS scores of group A and group B were observed at different time points after operation. Ramsay score, serum IL-6, serum IL-10 group, the difference was statistically significant (P 0.05); There was no significant difference between group A and group B in the scores of Ramsay, IL-6 and IL-10 in the whole group (P 0.05). There was significant difference in hemodynamic indexes between group A and group B after anesthesia (P 0.05). Conclusion both hydroxycodone and hydromorphone can effectively relieve postoperative pain in patients undergoing laparoscopic cholecystectomy, regulate the balance of proinflammatory and anti-inflammatory cytokines, and weaken the inflammatory response. To promote postoperative recovery.
【作者单位】：河南大学第一附属医院;
【分类号】：R614
【正文快照】： 表1两组患者一般情况比较(n=20,x±s)组别男/女/例年龄/岁体重/kg手术时间/minA组12/9 45.3±5.7 60.2±5.9 64.8±12.6B组12/8 44.5±5.4 60.8±6.6 66.2±13.2近年来,腹腔镜胆囊切除术广泛应用于胆囊疾病的临床治疗中,与传统开腹手术相比,该方法具有创伤小、失血少、机体恢

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