氢吗啡酮对妇科腹腔镜手术患者围术期细胞因子的影响

发布时间：2019-02-15 21:59

【摘要】：目的探讨氢吗啡酮对妇科腹腔镜手术患者围术期应激因子和炎性因子水平的影响。方法选择2015年1—12月绍兴市妇幼保健院全麻下行妇科腹腔镜手术患者100例作为研究对象,随机将其分为氢吗啡酮组和芬太尼组,每组各50例。ELISA法测定血清皮质醇、去甲肾上腺素、肾上腺素、C反应蛋白、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)和白细胞介素-6(IL-6)水平。结果与入室5 min比较,2组患者插管时平均动脉压和心率升高(P0.05),芬太尼组拔管后10 min平均动脉压和心率降低(P0.05);和芬太尼组比较,氢吗啡酮组拔管后10 min平均动脉压和心率升高(P0.05)。与入室5 min比较,2组插管时甲肾上腺素、肾上腺素水平升高(P0.05),皮质醇水平降低(P0.05),拔管后10 min芬太尼组去甲肾上腺素水平升高(P0.05);与芬太尼组比较,氢吗啡酮组插管时去甲肾上腺素和肾上腺素水平降低(P0.05),皮质醇水平升高(P0.05)。与入室5 min比较,2组手术30 min、手术结束、术后1 h的TNF-α和IL-6水平升高(P0.05),2组手术结束和术后1 h的IL-10水平升高(P0.05);与芬太尼组比较,氢吗啡酮组手术30 min、手术结束、术后1 h的TNF-α和IL-6水平降低(P0.05),手术结束和术后1 h的IL-10水平升高(P0.05)。结论氢吗啡酮用于全麻妇科腹腔镜手术,围手术期血流动力学较稳定,可减轻围手术期应激反应和炎症反应。
[Abstract]:Objective to investigate the effect of hydromorphine on perioperative stress factors and inflammatory factors in patients undergoing gynecologic laparoscopic surgery. Methods from January to December 2015, 100 patients undergoing gynecological laparoscopic surgery under general anesthesia in Shaoxing Maternal and Child Health Hospital were randomly divided into hydromorphine group and fentanyl group, 50 cases in each group. Serum cortisol was determined by ELISA method. Norepinephrine, C-reactive protein, tumor necrosis factor- 伪 (TNF- 伪), interleukin-10 (IL-10) and interleukin-6 (IL-6). Results compared with 5 min, the mean arterial pressure and heart rate increased during intubation in both groups (P0.05), and decreased 10 min after extubation in fentanyl group (P0.05). Compared with fentanyl group, the mean arterial pressure and heart rate increased 10 min after extubation in hydromorphine group (P0.05). Compared with 5 min, the levels of epinephrine and adrenaline increased (P0.05), cortisol decreased (P0.05), and noradrenaline increased 10 min after extubation in fentanyl group (P0.05). Compared with fentanyl group, norepinephrine and epinephrine levels were decreased and cortisol levels were increased in hydromorphine group (P0.05). Compared with 5 min after operation, the levels of TNF- 伪 and IL-6 increased 1 hour after operation in both groups (P0.05), and IL-10 level increased at 1 hour after operation in both groups (P0.05). Compared with fentanyl group, the levels of TNF- 伪 and IL-6 in hydromorphine group decreased 1 h after 30 min, operation (P0.05), and IL-10 level increased at 1 h after operation (P0.05). Conclusion the hemodynamics of hemodynamics in general anesthesia and gynecologic laparoscopic surgery is stable, and the stress and inflammation can be alleviated during the perioperative period.
【作者单位】：绍兴市妇幼保健院麻醉科;浙江省人民医院产科;
【基金】：2014浙江省医药卫生科技计划项目(2014KYB033)
【分类号】：R614

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