帕瑞昔布钠对腹腔镜下阑尾切除术患者术后疼痛及血清β-内啡肽、HSP70、IL-6水平的影响
摘要
目的观察帕瑞昔布钠对腹腔镜下阑尾切除术患者术后疼痛及血清β-内啡肽(β-EP)、热休克蛋白(HSP70)、白细胞介素-6(IL-6)水平的影响。方法将92例腹腔镜下阑尾切除术患者随机分为2组,2组均应用气管内插管静吸复合全麻,观察组46例术前给予静脉注射40 mg帕瑞昔布钠,对照组46例术前给予静脉注射等容量生理盐水。记录2组手术基本情况,对比2组术后疼痛及血清β-EP、HSP70、IL-6水平变化,统计2组术后不良反应出现情况。结果观察组和对照组手术时间、术中出血量比较,差异无统计学意义(P> 0. 05);观察组术后2、4、8、12、24 h疼痛VAS评分均显著低于对照组(P <0. 05);观察组手术结束时、术后6、12、24 h血清β-EP、IL-6水平均显著低于对照组(P <0. 05),血清HSP70水平均显著高于对照组(P <0. 05);观察组术后不良反应发生率[8. 70%(4/46)]显著低于对照组[28. 26%(13/46)](P <0. 05)。结论帕瑞昔布钠用于腹腔镜下阑尾切除术,能明显缓解术后疼痛,改善血清β-EP、HSP70、IL-6水平。
引文
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[15]徐枫,杨承祥,仲吉英,等.术前静脉注射帕瑞昔布钠对膝关节置换术患者IL-6、IL-10、TNF-α和VCAM-1的影响[J].广东医学,2011,32(6):791-793. DOI:10. 3969/j. issn. 1001-9448.2011. 06. 045.
[16]苏玉强,郑仲磊,李静,等.诱导前帕瑞昔布钠干预对腹腔镜手术后炎症应激反应、内分泌稳态的影响[J].海南医学院学报,2017,23(12):1640-1643. DOI:10. 13210/j. cnki. jhmu.20170627. 009.
[2]陶新发,黄文,周维肖.小儿腹腔镜阑尾切除术后疼痛的危险因素分析[J].腹腔镜外科杂志,2014,19(10):792-795.
[3]张伟,杜金娥.帕瑞昔布钠对老年腹腔镜手术患者丙泊酚复合瑞芬太尼麻醉效果及术后恢复的影响[J].海南医学院学报,2016,22(12):1279-1282. DOI:10. 13210/j. cnki. jhmu.20160302. 006.
[4]晁华绒,王晖,张昕,等.多模式镇痛用于腹腔镜胆囊切除术后镇痛效果的临床观察[J].陕西医学杂志,2011,40(8):1001-1003. DOI:10. 3969/j. issn. 1000-7377. 2011. 08. 025.
[5]徐秀征,何农,陆希,等.多模式超前镇痛对腹腔镜胆囊切除术全麻恢复期及术后疼痛的影响[J].临床和实验医学杂志,2016,15(9):913-917. DOI:10. 3969/j. issn. 1671-4695. 2016. 09. 032.
[6]胡曦丹,王卓.选择性环氧合酶-2(COX-2)非甾体抗炎药的安全性与有效性[J].药学服务与研究,2016,16(2):81-85.DOI:10. 5428/pcar20160201.
[7] Alanazi AM,El-Azab AS,Al-Suwaidan IA,et al. Structure-based design of phthalimide derivatives as potential cyclooxygenase-2(COX-2)inhibitors:anti-inflammatory and analgesic activities[J]. Eur J Med Chem,2015,92:115-123. DOI:10. 1016/j. ejmech. 2014. 12. 039.
[8]饶跃峰,王融溶,卢晓阳,等.加速康复外科围手术期疼痛管理中非甾体抗炎药的应用进展[J].中华普通外科杂志,2017,32(3):282-284. DOI:10. 3760/cma. j. issn. 1007-631X. 2017.03. 035.
[9] Camu F,Borgeat A,Heylen RJ,et al. Parecoxib,propacetamol,and their combination for analgesia after total hip arthroplasty:a randomized non-inferiority trial[J]. Acta Anaesthesiol Scand,2017,61(1):99-110. DOI:10. 1111/aas. 12841.
[10]顾学明.探讨帕瑞昔布钠用于腹腔镜下阑尾切除术术后镇痛的临床效果[J].系统医学,2017,2(14):59-62. DOI:10.19368/j. cnki. 2096-1782. 2017. 14. 059.
[11] Noveck RJ,Hubbard RC. Parecoxib sodium,an injectable COX-2-specific inhibitor,does not affect unfractionated heparin-regulated blood coagulation parameters[J]. J Clin Pharmacol,2004,44(5):474-480. DOI:10. 1177/0091270004264166.
[12] Lee S,Nam D,Kwon M,et al. Electroacupuncture to alleviate postoperative pain after a laparoscopic appendectomy:study protocol for a three-arm,randomised,controlled trial[J]. BMJ Open,2017,7(8):e015286. DOI:10. 1136/bmjopen-2016-015286.
[13] Panerai AE,Vecchiet J,Panzeri P,et al. Peripheral blood mononuclear cell beta-endorphin concentration is decreased in chronic fatigue syndrome and fibromyalgia but not in depression:preliminary report[J]. Clin J Pain,2002,18(4):270-273.
[14]李文彬,陈学新,马富强,等.帕瑞昔布钠与地佐辛超前镇痛对甲状腺术后镇痛效果比较及对β-内啡肽的影响[J].宁夏医学杂志,2015,37(2):122-124. DOI:10. 13621/j. 1001-5949.2015. 02. 0122.
[15]徐枫,杨承祥,仲吉英,等.术前静脉注射帕瑞昔布钠对膝关节置换术患者IL-6、IL-10、TNF-α和VCAM-1的影响[J].广东医学,2011,32(6):791-793. DOI:10. 3969/j. issn. 1001-9448.2011. 06. 045.
[16]苏玉强,郑仲磊,李静,等.诱导前帕瑞昔布钠干预对腹腔镜手术后炎症应激反应、内分泌稳态的影响[J].海南医学院学报,2017,23(12):1640-1643. DOI:10. 13210/j. cnki. jhmu.20170627. 009.