【摘要】 目的探讨术前输注氟比洛芬酯对开腹子宫切除术患者围术期血浆IL-2、IL-10表达的影响。方法择期行子宫切除术患者60例,ASAⅠ～Ⅱ级,随机分两组,氟比洛芬酯组和芬太尼组,每组30例。氟比洛芬酯组在手术切皮前5min静脉输注氟比洛芬酯1mg/kg,芬太尼组在手术切皮前5min静脉输注芬太尼1μg/kg,术毕两组静脉自控镇痛(PCIA),镇痛液组方按芬太尼2μg/kg加0.9%氯化钠溶液配成100mL,以2mL/h恒速泵注,自控给药剂量0.5mL/次,锁定时间15min,视觉模拟评分法(VAS)行术后12、24及48h静止和活动评分,分别在开放静脉前(T1)、手术结束时(T2)、术后24h(T3)、术后48h(T4)采取外周静脉血4mL,用放免法检测血浆白介素IL-2浓度,酶联免疫吸附(ELISA)法检测IL-10。结果氟比洛芬酯组在T2、T3时IL-2、IL-10明显高于芬太尼组(P﹤0.05)。两组患者在各时间点的视觉模拟评分(VAS值)差异无统计学意义(P>0.05)。结论术前输注氟比洛芬酯可抑制开腹子宫切除术患者的炎症反应,改善机体免疫功能。更多还原

【Abstract】 Objective To discuss the effect of preoperative infusion of flurbiprofen axetil to the expression of plasma IL-2 and IL-10 of patients in the perioperative stage who went abdominal hysterectomy. Methods Sixty Ⅰ-Ⅱ stage of ASA patients went selective operation in our hospital were randomly divided into two groups, flurbiprofen axetil group and fentanyl group, with 30 patients respectively. In the flurbiprofen group, patients were given 1 mg/kg infusion of flurbiprofen axetil 5 minutes before skin incision while patients in the fentanyl group were given 1 mg/kg infusion of fentanyl 5 minutes before skin incision. The two groups were given patient controlled intravenous analgesia (PCIA), analgesic liquid prescription was 2 μg/kg fentanyl dissolved in 0.9% saline to 100 mL. Constant speed pump was set at the rate of 2 mL/h. Patients’ controlled analgesic drug were set at the dosage of 0.5 mL/time, time were locked for 15 minutes. Visual analog scale (VAS) were conducted at 12, 24 and 48 h after operation to give stationary and moving score. 4 mL peripheral venous blood from the patients were taken before open vein (T1), at the end of surgery (T2), 24 hours after surgery (T3) and 48 hours after surgery (T4) respectively to test plasma concentration of IL-2 and IL-10. IL-2 was detected by radioimmunoassay, and IL-10 was detected by enzyme-linked immunosorbent assay (ELISA). Results Statistically significant differences existed at the time point of T2 and T3 (P < 0.05), patients in flurbiprofen axetil group had higher IL-2 and IL-10 level than that in fentanyl group. There was no significant difference in visual analog scale (VAS) at all time points between the two groups (P > 0.05). Conclusion Preoperative infusion of flurbiprofen axetil can effectively inhibit inflammatory response and improve immune function to abdominal hysterectomy patients.更多还原