摘要
目的探讨药物干预(加巴喷丁、糖皮质激素)对腹腔镜下子宫全切(TLH)患者术后快速康复及血清炎性因子的影响。方法选取2016年7月—2017年7月于西安医学院第一附属医院(全科医学院)妇科住院接受腹腔镜下子宫全切术治疗的患者50例,随机分为2组(n=25),实验组患者在术前2 h给予口服加巴喷丁及糖皮质激素;对照组患者术前2 h给予口服安慰剂药物;分别记录2组患者术后1、6、12、24 h视觉模拟评分法(visual analogue scale,VAS)数值,以及2组患者术后首次按压静脉自控镇痛(patient-controlled intravenous analgesia,PCIA)泵的给药时间和PCIA药物24 h的累积使用量;术后患者首次下床活动及肠道排气时间、住院时间以及恶心呕吐等不良反应发生率;于入手术室时,术后4、8、12 h分别抽取患者肘静脉血,ELISA测定血清中炎性因子白介素-6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)的表达水平。结果实验组患者术后1、6 h VAS评分低于对照组(均P <0. 05);实验组患者术后首次按压PCIA泵给药时间以及PCIA药物24 h的累积使用量低于对照组(均P <0. 05);实验组患者术后首次下床活动及肠道排气时间、住院时间、恶心呕吐不良反应发生率均低于对照组(均P <0. 05);实验组患者血清中IL-6、TNF-α的表达水平在术后不同时间节点(4、8、12 h)均低于对照组,差异具有统计学意义(均P <0. 05)。结论术前加巴喷丁及糖皮质激素的联合应用干预,可降低手术应激及炎性因子产生,进而减少术后不良反应发生率,促进腹腔镜下子宫全切患者术后快速康复。
Objective To investigate the effect of application of dezocine combined with glucocorticoid on rapid recovery and serum inflammatory factor of total laparoscopic hysterectomy patients. Methods From July 2016 to July 2017 in The first affiliated hospital of Xi’ an medical university( School of General Medicine),50 total laparoscopic hysterectomy patients were involved and randomly divided into experimental group and control group( n = 25). Patients in the experimental group were given taking orally with dezocine and glucocorticoid at 2 h before surgery. Patients in the control group were given taking orally with placebo at the same time. After surgery 1,6,12 and 24 h to record visual analogue scale of the two groups;To record the first use time of PCIA and the 24 h cumulative usage amount of PCIA drugs of each groups.To record the first time to get out of bed,gut exhaust time,hospitalization time and the incidence of nausea and vomiting of each group. The venous blood when entering the operation room,2,4 and 12 h after operation was extracted. The inflammatory factors( IL-6 and TNF-α) in serum were detected by ELISA. Results Compared with the control group,the VAS after surgery 1,6 h of experimental group were lower than the control group,and the differences were statistically significant( P < 0. 05). The first use time of PCIA and the 24 h cumulative usage amount of PCIA drugs of the experimental group were lower( P < 0. 05). The first time to get out of bed,gut exhaust time,hospitalization time and the incidence of nausea and vomiting of the experimental group were lower( P < 0. 05). The inflammatory factors( IL-6 and TNF-α) in serum of experimental group were lower than the control group( P < 0. 05),and all the differences were statistically significant. Conclusion Application of dezocine combined with glucocorticoid could could reduce surgical stress and inflammatory factors,as well as the incidence of adverse reactions after surgery and promote rapid recovery of total laparoscopic hysterectomy patients.
作者
李静
杨洋
韩彬
张少华
周小兰
LI Jing;YANG Yang;HAN Bin(Nursing College of Xi'an Medical University,Xi'an,Shaanxi 710021,China)
出处
《中华全科医学》
2019年第1期87-90,共4页
Chinese Journal of General Practice
基金
陕西省社会发展科技攻关项目(2016SF-111)
西安医学院护理学省级重点学科建设项目(16hlxk06)
关键词
加巴喷丁
糖皮质激素
术后快速康复
炎性因子
子宫全切
Dezocine
Glucocorticoid
Rapid postoperative recovery
Inflammatory factor
Total hysterectomy
