舒芬太尼在宫颈癌根治术中的应用效果
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摘要
目的观察舒芬太尼在宫颈癌根治术中的应用效果。方法按照随机数字表法将75例接受宫颈癌根治术的宫颈癌患者随机分为芬太尼组35例和舒芬太尼组40例,观察并比较两组患者的应激指标[C反应蛋白(CRP)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)、肾上腺素、去甲肾上腺素]和免疫功能指标(CD3+、CD4+)水平、麻醉效果、镇静效果以及术后不良反应发生情况。结果术后4 h,舒芬太尼组患者的Cor、CRP、ACTH水平均明显低于芬太尼组患者(P﹤0.01)。术后24 h,舒芬太尼组患者的CD3+、CD4+水平均明显高于芬太尼组患者,肾上腺素、去甲肾上腺素水平均明显低于芬太尼组患者(P﹤0.01)。术后12 h,舒芬太尼组患者的VAS评分明显低于芬太尼组患者(P﹤0.01)。术后4、12 h,两组患者的Ramsay评分比较,差异均无统计学意义(P﹥0.05)。术后,两组患者的不良反应发生情况比较,差异无统计学意义(P﹥0.05)。结论舒芬太尼在宫颈癌根治术中的应用效果较好,应激反应较小,镇痛效果好,对患者免疫功能的影响小,具有良好的临床应用价值。
Objective To observe the clinical efficacy of sufentanil in cervical cancer patients undergoing radical hysterectomy. Method A total of 75 patients with cervical cancer who performed radical hysterectomy were collected and randomly allocated in fentanyl group(35 patients) and sufentanil group(40 patients) using a random number table. The indicators of stress and immune function index in the two groups were observed and compared, the indicators of stress include C-reactive protein(CRP), adrenocorticotropic hormone(ACTH), cortisol(Cor), adrenaline and norepinephrine; the indicators of immune function include CD3+and CD4+. The anesthetic effects, sedative effects and the occurrence of adverse reactions of the two groups were observed. Result After 4 hours of operation, the levels of Cor, CRP and ACTH in the sufentanil group were significantly lower than that in the fentanyl group(P<0.01); After 24 hours of operation, the levels of CD3+and CD4+were significantly higher than that in the fentanyl group, the levels of adrenaline and norepinephrine were significantly lower than that in the fentanyl group(P<0.01). At 12 hours after operation, the VAS scores of patients in the sufentanil group were significantly lower than those in the fentanyl group(P<0.01). After 4 hours and 12 hours of operation, there was no statistically significant difference between the Ramsay scores of the two groups(P>0.05). After operation, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion The clinical efficacy of sufentanil in radical cervical cancer hysterectomy is better, the stress response is smaller, the analgesic effect is good, the effect on the patient's immune function is small, has good clinical application value.
Objective To observe the clinical efficacy of sufentanil in cervical cancer patients undergoing radical hysterectomy. Method A total of 75 patients with cervical cancer who performed radical hysterectomy were collected and randomly allocated in fentanyl group(35 patients) and sufentanil group(40 patients) using a random number table. The indicators of stress and immune function index in the two groups were observed and compared, the indicators of stress include C-reactive protein(CRP), adrenocorticotropic hormone(ACTH), cortisol(Cor), adrenaline and norepinephrine; the indicators of immune function include CD3+and CD4+. The anesthetic effects, sedative effects and the occurrence of adverse reactions of the two groups were observed. Result After 4 hours of operation, the levels of Cor, CRP and ACTH in the sufentanil group were significantly lower than that in the fentanyl group(P<0.01); After 24 hours of operation, the levels of CD3+and CD4+were significantly higher than that in the fentanyl group, the levels of adrenaline and norepinephrine were significantly lower than that in the fentanyl group(P<0.01). At 12 hours after operation, the VAS scores of patients in the sufentanil group were significantly lower than those in the fentanyl group(P<0.01). After 4 hours and 12 hours of operation, there was no statistically significant difference between the Ramsay scores of the two groups(P>0.05). After operation, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion The clinical efficacy of sufentanil in radical cervical cancer hysterectomy is better, the stress response is smaller, the analgesic effect is good, the effect on the patient's immune function is small, has good clinical application value.
引文
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[8]陈敬锋,陈磊,余玮,等.舒芬太尼自控静脉镇痛对肺癌切除术后患者血流动力学及免疫功能的影响[J].现代生物医学进展,2016,16(11):2130-2133.
[9]张懿,苏文君,蒋春雷.应激生理指标皮质醇和α-淀粉酶的研究进展[J].军事医学,2017,41(2):146-149.
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[12]李文华,范卫捷,张群辉,等.高原低氧应激条件下促肾上腺皮质激素释放激素对免疫细胞作用机制的研究进展[J].中国全科医学,2017,20(36):4591-4597.
[13]冉茂荣,林露,牛洁,等.右美托咪啶复合舒芬太尼用于食道癌术后镇痛对机体免疫细胞的影响[J].四川医学2017,38(9):1043-1045.
[14]毕翻利,高洁.低剂量舒芬太尼复合地佐辛对老年胃癌患者认知功能及细胞免疫功能的影响[J].实用癌症杂志,2017,32(1):40-43.
[15]华彦珺,周芬,杨玉婷,等.肺结核患者外周血CD4+T细胞表达与不同检测方法结果分析[J].检验医学与临床,2017,14(5):687-689.
[2]彭丹晖,韦程瀚,黄薇,等.舒芬太尼用于腹腔镜宫颈癌根治术后靶控镇痛的临床研究[J].中国临床药理学杂志,2016,32(9):774-777.
[3]Qi Y,Yao X,Zhang B,et al.Comparison of recovery effect for sufentanil and remifentanil anesthesia with TCI in laparoscopic radical resection during colorectal cancer[J].Oncol Lett,2016,11(5):3361-3365.
[4]Ramsay MA,Savege TM,Simpson BR,et al.Controlled sedation with alphaxalone-alphadolone[J].Br Med J,1974,2(5920):656-659.
[5]刘欣,夏乐强.老年脊柱手术患者接受右美托咪定联合舒芬太尼自控静脉镇痛的神经功能评估[J].海南医学院学报,2016,22(17):2049-2052.
[6]董佳,王保国.等效镇痛剂量舒芬太尼和瑞芬太尼呼吸抑制作用的比较[J].中国医师进修杂志,2010,33(33):6-9.
[7]杨涛,周日永,张竞雄,等.右美托咪定在老年患者子宫颈癌根治术中对瑞芬太尼麻醉后痛觉过敏的影响[J].中国医药,2016,11(11):1687-1690.
[8]陈敬锋,陈磊,余玮,等.舒芬太尼自控静脉镇痛对肺癌切除术后患者血流动力学及免疫功能的影响[J].现代生物医学进展,2016,16(11):2130-2133.
[9]张懿,苏文君,蒋春雷.应激生理指标皮质醇和α-淀粉酶的研究进展[J].军事医学,2017,41(2):146-149.
[10]Guo S,He X,Chen Q,et al.The C-reactive protein/albumin ratio,a validated prognostic score,predicts outcome of surgical renal cell carcinoma patients[J].BMC Cancer,2017,17(1):171.
[11]Lieberman KV,Pavlova-Wolf A.Adrenocorticotropic hormone therapy for the treatment of idiopathic nephrotic syndrome in children and young adults:a systematic review of early clinical studies with contemporary relevance[J].JNephrol,2017,30(1):35-44.
[12]李文华,范卫捷,张群辉,等.高原低氧应激条件下促肾上腺皮质激素释放激素对免疫细胞作用机制的研究进展[J].中国全科医学,2017,20(36):4591-4597.
[13]冉茂荣,林露,牛洁,等.右美托咪啶复合舒芬太尼用于食道癌术后镇痛对机体免疫细胞的影响[J].四川医学2017,38(9):1043-1045.
[14]毕翻利,高洁.低剂量舒芬太尼复合地佐辛对老年胃癌患者认知功能及细胞免疫功能的影响[J].实用癌症杂志,2017,32(1):40-43.
[15]华彦珺,周芬,杨玉婷,等.肺结核患者外周血CD4+T细胞表达与不同检测方法结果分析[J].检验医学与临床,2017,14(5):687-689.