帕瑞昔布钠联合曲马多镇痛对悬雍垂腭咽成形术患者的影响

发布时间：2018-08-30 18:57

【摘要】：目的观察帕瑞昔布钠联合曲马多镇痛对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者行悬雍垂腭咽成形术(UPPP)后的镇痛效果、不良反应及炎性细胞因子水平的影响。方法将经多导睡眠仪(PSG)监测证实的60例OSAHS患者随机分为2个组,其中实验组(T组,30例)术前予帕瑞昔布钠联合曲马多镇痛,对照组(C组,30例)术前予曲马多镇痛,2个组UPPP术后均接受曲马多患者自控镇痛。统计2个组患者术后48 h内的疼痛视觉模拟评分(VAS),救援性镇痛药用量及不良反应发生率,并检测患者围手术期血清中肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和细胞间黏附因子-1(ICAM-1)等炎性细胞因子的浓度。结果与C组相比,T组在术后48 h内的VAS评分降低(P0.01),救援性镇痛药量减少(P0.05),不良反应发生率降低(P0.05)。T组患者血清TNF-α、IL-6浓度低于C组(P0.01或P0.05),而IL-10、ICAM-1浓度差异无统计学意义。结论帕瑞昔布钠联合曲马多镇痛用于OSAHS手术治疗术后镇痛效果良好,不良反应发生率低,并在一定程度上发挥抗炎作用,是UPPP围手术期较为理想的镇痛方法。
[Abstract]:Objective to observe the analgesic effect, side effect and inflammatory cytokine level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) treated by uvulopalatopharyngoplasty (UPPP) with pareoxib sodium and tramadol. Methods 60 patients with OSAHS confirmed by polysomnography (PSG) were randomly divided into 2 groups. The experimental group (group T, n = 30) was treated with paroxib sodium combined with tramadol analgesia before operation. The control group (group C, n = 30) received tramadol analgesia before operation, and both groups received tramadol patient-controlled analgesia after UPPP. The pain visual analogue score (VAS) of the two groups within 48 hours after operation was analyzed. The dosage of (VAS), relief analgesics and the incidence of adverse reactions were analyzed. The serum levels of tumor necrosis factor 伪 (TNF- 伪), interleukin-6 (IL-6), interleukin-10 (IL-10) and intercellular adhesion factor 1 (ICAM-1) were measured. Results compared with group C, the VAS score, the amount of relief analgesics and the incidence of adverse reactions in group T were lower than those in group C within 48 h (P0.01), and the incidence of adverse reactions in group T was lower than that in group C (P0.01 or P0.05). However, there was no significant difference in the concentration of IL-10,ICAM-1 between group T and group C (P0.01 or P0.05). Conclusion the analgesic effect of paroxib sodium combined with tramadol for postoperative analgesia in OSAHS operation is good, the incidence of adverse reactions is low, and the anti-inflammatory effect is played to a certain extent. It is an ideal analgesic method in perioperative period of UPPP.
【作者单位】：山东大学齐鲁医院麻醉科;山东大学齐鲁医院耳鼻咽喉头颈外科;
【分类号】：R766.7;;R614

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