【摘要】 目的 :探讨上腹部手术患者术后镇痛血清高敏C-反应蛋白 (hs-CRP)和肿瘤坏死因子-α(TNF-α)的变化规律及临床意义。方法 :4 0例择期行上腹部手术患者 ,随机分为传统方法镇痛组 (对照组 )和使用镇痛泵镇痛组 (镇痛泵组 ) ,每组 2 0例 ,分别于麻醉前、术中 1小时、术后 2 4、72和 12 0小时抽取静脉血 ,用胶乳增强免疫透射比浊法和ELISA双抗体夹心法分别检测hs CRP和TNF-α含量。结果 :镇痛泵组镇痛效果好于传统方法。术前两组患者血清hs-CRP和TNF-α水平无显著性差异(P >0.0 5 ) ,术后 2 4和 72小时两组hs-CRP水平明显升高 ,且镇痛泵组hs CRP浓度低于对照组 ,12 0小时高于对照组 ,差异具有显著性 (P <0.0 1) ;术后 72小时镇痛泵组TNF-α含量明显高于术前和对照组 ,12 0小时恢复至术前水平 ,但低于对照组 ,差异具有显著性 (P <0.0 1)。结论 :使用镇痛泵镇痛可减轻应激反应 ,术后监测hs-CRP和TNF-α浓度有利于创伤程度和预后判断 ,并可作为评价术后应激和镇痛效果指标更多还原

【Abstract】 Objective:To investigate the changes and the significance of high-sensitivity C-reactive protein (hs-CRP) and tumour necrosis factor α(TNF-α) of postopertive analgesia in patients undergoing upper abdominal surgery.Methods:Twenty patients assigned to analgesia pump group and twenty patients as the control.Hs-CRP and TNF-α concentrations were measured before induction of anesthesia,1 h after skin incision,24,72 and 120 h after surgery.Results:Effectiveness was more obvious in patients using analgesia pump.There were no significant changes of hs-CRP and TNF-α in both groups before operation (P>0.05),the hs-CRP values were significantly lower than those of control group (P<0.01);TNF-α concentrations in analgesia pump group at 72 h after surgery were significantly lower than that of control group (P<0.01).Conclusion:Monitoring the levels of the hs-CRP and TNF-α after surgery may help to evaluate severity of stress response to surgical trauma,analgesia and prognosis.更多还原