摘要
目的:探讨盐酸右美托咪定注射液联合酒石酸布托啡诺注射液对结直肠癌术后镇痛效果、炎症因子及早期恢复的影响。方法:选取2018年3月~2021年1月本院收治的120例结直肠癌患者,采用随机数字表法分为观察组和对照组,每组60例。对照组术后静脉自控镇痛(PCIA)方案为酒石酸布托啡诺注射液10mg+盐酸阿扎司琼注射液10mg+氯化钠注射液,观察组为盐酸右美托咪定注射液200μg+酒石酸布托啡诺注射液10mg+盐酸阿扎司琼注射液10mg+氯化钠注射液,比较两组术后6、12、24h和48h的视觉模拟量表(VAS)评分及术后恢复指标,术前、术后48h测定两组患者匹兹堡睡眠质量(PSQI)、恢复质量(QoR-40)评分,于术前、术后24h和48h采血检测患者血清炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(INF-γ)]及T细胞亚群水平,并记录两组不良反应发生情况。结果:观察组术后6、12、24h和48h的VAS评分低于对照组(P<0.05)。术后24h和48h,观察组血清CRP、IL-6、TNF-α、INF-γ和CD8^(+)水平低于对照组(P<0.05),CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平高于对照组(P<0.05)。观察组首次下床活动时间、首次排气时间、首次进食时间及术后住院时间短于对照组(P<0.05),不良反应发生率与对照组相比无统计学差异(P>0.05)。术前两组PSQI和QoR-40比较无统计学差异(P>0.05),术后观察组PSQI低于对照组,QoR-40高于对照组(P<0.05)。结论:结直肠癌术后采取盐酸右美托咪定注射液联合酒石酸布托啡诺注射液镇痛效果良好,可在一定程度上降低炎症因子的表达,促进患者术后恢复。
Objective:To investigate the influence of dexmedetomidine hydrochloride injection combined with metoprolol tartrate injection on the analgesic effects,inflammatory factors and early recovery conditions after operation of colorectal cancer.Methods:A total of 120 colorectal cancer patients treated from March 2018 to January 2021 in our hospital were selected,and were divided into the observation group and the control group according to random number table,60 cases in each group.Under patient-controlled intravenous analgesia(PCIA),the control group took 10 mg metoprolol tartrate injection+10 mg azasetron+0.9% sodium chloride;and the observation group took 200μg dexmedetomidine hydrochloride injection+10 mg metoprolol tartrate injection+10 mg azasetron+0.9% sodium chloride.Visual analogue scale(VAS)scores after 6,12,24 h and 48 h and postoperative recovery indicators,Pittsburgh sleep quality index(PSQI),and quality of recovery-40(QoR-40)scores before surgery and after 48 h of surgery,and serum inflammatory factors like C reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interferon-γ(INF-γ)and T-cell subsets before surgery,after 24 h and 48 h of surgery were compared between the two groups.The incidence of adverse reactions in the two groups was also recorded.Results:After 6,12,24 h and 48 h of surgery,VAS scores in the observation group were lower than that of control group(P<0.05);after 24 h and 48 h of surgery,the levels of serum CRP,IL-6,TNF-α,INF-γ and CD8^(+) in the observation group were lower than those of the control group(P<0.05);the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the observation group were higher than those of the control group(P<0.05);the first initial ambulant time,first exhaust time,first feeding time and hospital stays in the observation group were shorter than those of the control group(P<0.05);there was no statistical difference in the incidence rate of adverse reactions between the control group and the control group(P>0.05).There was no significant dif
作者
郭浩翔
卫利民
谢小娟
GUO Hao-xiang;WEI Li-min;XIE Xiao-juan(Anesthesiology Department,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Thyroid&Breast Surgery Department,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《中国合理用药探索》
2022年第6期70-76,共7页
Chinese Journal of Rational Drug Use
关键词
盐酸右美托咪定注射液
酒石酸布托啡诺注射液
术后镇痛
炎症反应
术后恢复
dexmedetomidine hydrochloride injection
metoprolol tartrate injection
postoperative analgesia
inflammatory response
postoperative recovery
