摘要
目的探索术中使用乌司他丁联合氟比洛芬酯对结肠癌手术患者炎症反应及快速康复效果的影响。方法选择腹腔镜下结肠癌根治术患者80例,电脑随机分组分为乌司他丁(W)组、氟比洛芬酯(F)组、乌司他丁+氟比洛芬酯(WF)组及对照(C)组,每组20人。手术采用全麻气管插管,麻醉诱导后采用静吸复合麻醉,使用丙泊酚、瑞芬太尼、顺势阿曲库铵联合七氟醚维持麻醉。W组在术前、手术结束时给予乌司他丁5000 U/kg。F组在术前、术后24、48、72 h给予氟比洛芬酯50 mg,WF组于术前、手术结束时给予乌司他丁5000 U/kg,于术前、术后24、48、72 h给予氟比洛芬酯50 mg,C组在WF组给药同样时间给予同等体积生理盐水。W组、F组在WF组用药而本组不用药时也给予同等体积生理盐水。患者都采用切口局部麻醉镇痛,不使用阿片类术后镇痛药。于麻醉前(T1)、术后6 h(T2)、24 h(T3)、72 h(T4)对患者进行VAS疼痛评分,取静脉血浆检测患者炎症因子TNF-α,IL-1β含量。记录患者首次肛门排气时间、首次下床活动时间、术后住院时间。结果与C组比较,W组、F组、WF组的T2、T3、T4时间点血浆TNF-α与IL-1β含量较低(P<0.05),VAS疼痛评分较低(P<0.05),术后肛门首次排气时间、首次下床活动时间较早(P<0.05)。与WF组比较,W组、F组的T2、T3、T4时间点血浆TNF-α与IL-1β含量较高(P<0.05),VAS疼痛评分较高(P<0.05),术后肛门首次排气时间、首次下床活动时间较晚(P<0.05)。各组术后住院时间差异无明显意义(P>0.05)。结论在结肠癌根治术术中使用乌司他丁联合氟比洛芬酯有助于减轻患者炎症反应,减轻患者术后疼痛,加快患者术后快速康复。
Objective To investigate the effects of ulinastatin combined with flurbiprofen axetil on the inflammatory response and speedy recovery of patients undergoing colon cancer surgery. Methods Eighty cases with colon cancer scheduled for laparoscopic surgery were selected. The patients were randomly divided into 4 groups （n=20）： ulinastatin group（group W）, flurbiprofen axetil group（group F）, ulinastatin ＋ flurbiprofen axetil group（group WF）, and control group（group C）. The operation was performed with endotracheal intubation under general anesthesia followed by intravenous-inhalation combined anesthesia. Propofol, remifentanil, cisatracurium and sevoflurane were used to maintain anesthesia. Patients in group W were injected with ulinastatin （5000 U/kg） before and instantly after surgery. Patients in group F were injected with flurbiprofen axetil （50 mg） before and 24, 48, 72 h after the surgery. Patients in group WF were injected with ulinastatin （5000 U/kg） before and instantly after the surgery.Meanwhile, they were also injected with flurbiprofen axetil （50 mg） before and 24, 48, 72 h after the surgery. Patients in group C, W, and F were given the same volume of saline as group WF patients in appropriate time. Patients were treated with local anesthetic instead of opioid analgesics in postoperative care. The Visual Analogue Scale （VAS） was performed to evaluate the pain score for patients before surgery at T1 and 6 h（T2）, 24 h（T3）, 72 h（T4） after the surgery. The levels of inflammatory cytokines in the venous plasma were detected, including TNF-α and IL-1β. The time of first exsufflation, first off-bed activity and postoperative hospital stay were recorded. Results Compared with group C, the plasma levels of TNF-αand IL-1β in group W, F and WF decreased significantly at T2, T3, T4 （P〈0.05）. VAS pain scores were obviously lower （P〈0.05）. The time of first exsufflation and the time of first off-bed activity were significantly earlier （P〈0.05�
出处
《分子影像学杂志》
2018年第1期89-92,共4页
Journal of Molecular Imaging
