【摘要】 目的评价帕瑞昔布钠对拟行肺叶切除术患者抗炎作用及镇痛效果。方法 40例拟行肺切除术患者随机分为帕瑞昔布钠组(P组)和对照组(C组),每组20例。P组于麻醉诱导前静脉注射首剂帕瑞昔布钠40 mg,首剂药物后12,24,36 h,静脉注射帕瑞昔布钠40 mg;C组在4个时间点均注射生理盐水。PCA镇痛开始后12,24,36和48 h记录疼痛视觉模拟评分(VAS)及Ramsay镇静程度评分。分别于患者麻醉前、手术结束时、术后12,24 h抽取静脉血样,测定血浆白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)浓度。结果 2组患者疼痛评分差异无统计学意义;Ramsay镇静程度评分,P组显著低于C组(P<0.05);P组恶心、呕吐发生率显著低于C组(P<0.05);手术结束时至术后24 h IL-6水平,P组明显低于C组(P<0.05),术后12,24 hIL-8与TNF-α水平,P组明显低于C组(P<0.05)。结论帕瑞昔布钠可对肺叶切除术患者产生良好的镇痛效果,降低炎性因子水平。更多还原

【Abstract】 Objective To investigate parecoxib sodium on inflammatory factors and postoperative analgesia in patients undergoing lobectomy.Methods Forty patients were randomly allocated to parecoxib group(group P,n=20) and control group(group C,n=20).Group P received intravenous parecoxib 40 mg before anesthesia induction,and received intravenous parecoxib 40 mg at 12,24 and 36 h after the first dose.At the same time,group C received intravenous normal saline respectively.The following indexes were recorded at 12,24,36 and 48 h after the operation:VAS scores of pain,sedation score,delivery,drug dose,and side effects.Venous blood samples were taken before anesthesia induction,at the end of operation,at 12 h and 24 h after operation for determination of serum IL-6,IL-8 and TNF-α concentrations.Results There were no significant difference in VAS scores(P>0.05).Sedation score,delivery and drug dose in group P were significantly lower than in group C after the PCA pumps were used(P<0.05).The incidence of nausea and vomit in group P were significantly lower than in group C(P<0.05).Compared with group C,serum IL-6 concentrations was significantly lower at the end of operation,at 12 h and 24 h after operation in group P,and serum IL-8 and TNF-α concentrations were significantly lower at 12 h and 24 h after operation in group P. Conclusion Parecoxib sodium can relief pain and decrease inflammatory factors levels in patient undergoing lobectomy efficiently.更多还原