摘要
目的探究帕瑞昔布钠预先镇痛对胃癌根治术患者镇痛效果及术后细胞免疫功能的影响。方法选取我院胃癌根治术患者70例，采用随机数字表法分为帕瑞昔布钠组（A组）和生理盐水组（B组），每组35例。术前30minA组患者静脉注射帕瑞昔布钠，B组患者注射生理盐水，术后两组患者均进行芬太尼自控镇痛。采用视觉模拟评分（VAS）评价两组患者术后2、6、12、24h安静痛和咳嗽痛改善情况，并记录T淋巴细胞亚群细胞分化抗原（CD3＋、CD4＋、CD8＋、CD4＋／CD8＋）以及NK细胞水平的变化以及不良反应。结果两组患者术后安静痛和咳嗽痛VAS评分均逐渐降低，A组患者术后6、12、24h评分均明显低于术后2h（P〈0.05），术后12、24h评分均明显低于术后6h（P〈0．05），术后24h评分均明显低于术后12h（P〈0．05）；B组术后6、12、24h评分均明显低于术后2h（P〈0．05），术后24h评分均明显低于术后6、12h（P〈0．05）。A组患者术后2、6、12、24h安静痛和咳嗽痛VAS评分明显低于B组患者，差异均有统计学意义（P〈0．05）。CD3＋、CD4＋、CD8＋、CD4＋／CD8＋、NK细胞水平均高于B组（P〈0．05）；A组患者不良反应率为28．6％（10例／35例）；B组患者不良反应率为40％（14例／35例），两组比较差异无统计学意义（P〉0．05）。结论帕瑞昔布钠预先镇痛能提高胃癌根治术患者术后的镇痛效果，减轻患者术后T淋巴细胞亚群及NK细胞数量下降的程度。
Objective To explore the effects of parecoxib preemptive analgesia and influences to cellular immune function after operation in patients with radical gastric cancer operation. Methods Seventy patients with radical gastric cancer operation were randomly divided into parecoxib group （group A） and normal saline group（group B）, with 35 cases in each group. The patients in group A were given preemptive analgesia with intravenous parecoxib sodium at 30 min before operation, and group B were given intravenous normal saline at the same time. All of the patients were carried out with fentanyl for postoperative analgesia. The rest pain and cough pain were evaluated with visual analogue scale（VAS） in the two groups at 2,6, 12 and 24 h after operation. T lymphocyte subsets of CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ as well as the the levels of NK cells and the adverse reactions were recorded. Results The VAS of rest and cough pain were gradually reduced in the two groups,of which VAS in group A at postoperative 6, 12, 24 h was significantly lower than that at postoperative 2 h （P〈 0.05）, and VAS in group A at postoperative 12,24 h was significantly lower than that at postoperative 6 h（P〈 0.05 ）, and VAS in group A at postoperative 24 h was significantly lower than that at postoperative 12 h（ P 〈 0.05 ）. The VAS in group B at postoperative 6, 12, 24 h was significantly lower than that at postoperative 2 h （P〈 0.05）, and VAS at postoperative 24 h was significantly lower than that at postoperative 6 h and 12 h. The VAS of rest and cough pain in group A at 2,6, 12,24 h after operation was Significantly lower than that in group B （P〈 0.05）. The levels of CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ and NK cells in group A were significantly higher thanthose in group B （P 〈 0.05）. The rate of adverse reactions in group A was 28.6% （10/35 cases）, which was 40% （14/35 cases）in group B, and the difference was not statistically significant between the two groups （P 〉 0.05 ）. Coneht
出处
《实用疼痛学杂志》
2016年第3期194-197,共4页
Pain Clinic Journal
关键词
预先镇痛
帕瑞昔布钠
胃癌
芬太尼
免疫
细胞
Preemptive analgesia
Parecoxib
Gastric cancer
Fentanyl
Immunity, cellular
