摘要
目的探讨羟考酮联合帕瑞昔布钠对腹腔镜胆囊切除术后镇痛效果及炎性反应、应激反应的影响。方法选取医院2015年4月至2018年3月收治的行腹腔镜胆囊切除术患者97例,根据随机数字表法分为对照组(48例)和研究组(49例)。对照组患者给予帕瑞昔布钠联合吗啡治疗,研究组患者给予羟考酮联合帕瑞昔布钠治疗。结果两组患者术后1 d(T1)、术后2 d(T2)的视觉模拟评分(VAS)均较术后即刻(T0)明显降低,且研究组显著低于对照组(P <0. 05);两组患者T1,T2时白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)均较T0时升高,且研究组显著低于对照组(P <0. 05);两组患者T1,T2时去甲肾上腺素(NE)、胰岛素(INS)、皮质醇(Cor)均较T0时升高,且研究组显著低于对照组(P <0. 05);研究组不良反应发生率为10. 20%(5/49),显著低于对照组的31. 25%(15/48,P <0. 05)。结论羟考酮联合帕瑞昔布钠对腹腔镜胆囊切除术后镇痛效果较佳,可显著降低炎性因子水平,减轻应激反应,同时安全性较好。
Objective To investigate the effect of oxycodone combined with parecoxib sodium on analgesia,inflammatory response and stress response after laparoscopic cholecystectomy. Methods Totally 97 patients underwent laparoscopic cholecystectomy admitted to our hospital from April 2015 to March 2018 were selected and divided into the control group( 48 cases) and the study group( 49 cases)according to the random number table method. The patients in the control group were treated with parecoxib sodium combined with morphine,while the patients in the study group were treated with oxycodone combined with parecoxib sodium. Results 1 day( T1) and 2 days( T2) after operation,the scores of visual analogue scale( VAS) in the two groups were significantly lower than those at immediately after operation( T0),and those in the study group were significantly lower than those in the control group( P < 0. 05). The levels of interleukin-6( IL-6),C-reactive protein( CRP) and tumor necrosis factor-α( TNF-α) in the two groups at T1 and T2 were higher than those at T0,the levels in the study group were significantly lower than those in the control group( P < 0. 05). The levels of norepinephrine( NE),insulin( INS) and cortisol( Cor) in the two groups at T1 and T2 were higher than those at T0,the levels in the study group were lower than those in the control group( P < 0. 05). The incidence rate of adverse reactions in the study group was 10. 20%( 5/49),which was significantly lower than 31. 25%( 15/48) in the control group( P < 0. 05). Conclusion Oxycodone combined with parecoxib sodium has good analgesic effect and safety after laparoscopic cholecystectomy,it can significantly reduce the levels of inflammatory factors and stress response.
引文
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