摘要
目的观察氯诺昔康超前镇痛对胆道手术病人炎性细胞因子表达的影响。方法选择择期行开腹胆道手术患者40例,随机分为L、H两组,每组20例。L组患者麻醉诱导前静注氯诺昔康8mg,术后以芬太尼行静脉给药病人自控镇痛(PCIA);H组患者关腹结束时静注氯诺昔康8mg,术后也以芬太尼行PCIA。于麻醉诱导前和关腹结束时(均未给予氯诺昔康前,分别记为术前与术后0h)、术后6h、24h4个时点抽取外周静脉血,测定血清炎性细胞因子包括促炎因子白细胞介素-2(IL-2)和白细胞介素-6(IL-6),抗炎因子白细胞介素-10(IL-10)。结果两组患者术前血清IL-2、IL-6浓度变化无显著差异(P>0.05),术后0、6及24h,H组IL-2、IL-6水平显著高于L组(P<0.05)。血清IL-10浓度术前两组无差异(P>0.05),术后0、6及24h,H组IL-10水平明显低于L组(P<0.05)。结论术前使用较术后使用氯诺昔康镇痛能更有效地抑制术后炎性因子的分泌并促进抗炎因子的产生。
[ Objective ] To observe the effects of pre-emptive analgesia with lomoxicam on the expression of pro-inflammatory cytokines on biliary tract operation. [ Methods ] 40 cases who undergoing the selective open bile duet operation, were selected and randomly allocated into two groups with 20 cases each, group L and group H. Pa- tients in group L were given Lomoxicam 40 mg iv before the induction of anesthesia. After the operation, Fentanyl was administered via PCA. In group H, patients were given Lomoxicam 8 mg at the end of operation. After the operation, Fentanyl was also administered via PCA. The levels of proinflammatory factors IL-2 and IL-6, anti-inflammatory factor IL-10 in serum ahead of anesthesia induction and at Oh, 6h, 24h after operation were measured by radioimmunoassay. [Results] There was no significantly difference between group L and group H in serum levels of IL-2 and IL-6 ahead of anesthesia induction （P 〉0.05）. The serum levels of IL--2 and IL-6 in group H were significantly higher than group L at 0 h, 6 h, 24 h after operation （P 〈0.05）. There was no significant difference between group L and group H in serum levels of IL-10 ahead of anesthesia induction （P 〉0.05）. The serum levels of IL-10 in group H was significandy decreased at 0 h, 6 h, 24 h after operation （P 〈0.05）. [ Conclusion] Pre-emptive analgesia with Lomoxicam could inhibit the formation of inflammatory factors but activate the production of auti-inflammatory factors.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2009年第22期3429-3431,共3页
China Journal of Modern Medicine
关键词
氯诺昔康
超前镇痛
炎性细胞因子
Lornoxicam
pre-emptive analgesia
pro-inflammatory cytokines
