【摘要】 目的观察右美托咪定联合氟比洛芬酯对胆囊切除术后患者镇痛效果、凝血功能及免疫功能的影响。方法选取行胆囊切除术的患者90例,采用随机数字表法分为对照组与观察组,每组45例。对照组给予右美托咪镇痛治疗,观察组在对照组治疗基础上,给予氟比洛芬酯镇痛治疗。分别于术后3 h、24 h对两组患者进行VAS及BCS评分;分别于术前及术后7 d检测两组患者凝血功能及免疫功能水平的变化。结果术后3 h,两组患者VAS及BCS评分比较,差异无统计学意义(P> 0.05);术后24 h,两组患者VAS评分均明显减小,BCS评分均明显增大,且观察组术后24 d的BCS评分明显高于对照组,差异均有统计学意义(P <0.05)。术前,两组患者血清中活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶原时间(PT)、D-二聚体(DD)、CD3~+、CD4~+、CD8~+、CD4~+/CD8~+水平比较,差异无统计学意义(P> 0.05)。手术7 d后,与本组术前比较,两组患者血清中FIB、DD、CD3~+、CD4~+及CD4~+/CD8~+水平均明显升高;且观察组患者血清中FIB、DD、CD3~+、CD4~+及CD4~+/CD8~+水平均明显高于对照组,差异有统计学意义(P <0.05)。结论采用右美托咪定联合氟比洛芬酯进行胆囊切除术术后静脉镇痛效果较好,对患者凝血功能影响小,可显著增强患者免疫功能,提高生存质量。更多还原

【Abstract】 Objective To investigate the effect of Dexmedetomidine combined with Flurbiprofen Axetil on analgesia, coagulation function and immunologic function in patients after cholecystectomy. Methods A total of 90 patients undergoing cholecystectomy in the hospital were randomly divided into the control group and the observation group, 45 cases in each group. The patients in control group were treated by Dexmedetomidine; while patients in observation group were treated by Flurbiprofen Axetil on the basis of Dexmedetomidine treatment. VAS and BCS scores in patients of 2 groups were evaluated at 3 h and 24 h after operation. Levels of coagulation function and immune function of patients in 2 groups were detected at 7 th day after operation. Results There was no significant difference in VAS and BCS scores between the 2 groups at 3 h after the operation( P > 0.05). The scores of VAS in the 2 groups were significantly reduced and the score of BCS increased obviously at 24 h after the operation. The scores of BCS in the observation group were significantly higher than those of the control group. The difference was statistically significant(P < 0.05). Before operation, there was no statistically significant difference between the levels of APTT, FIB, PT, DD, CD3~+, CD4~+, CD8~+, CD4~+/CD8~+ in 2 group(P > 0.05). At 7 d after the operation, comparison with the group before operation, the levels of FIB, DD, CD3~+, CD4~+, CD4~+/CD8~+ in the serum of patients in the control group and the observation group were significantly increased. The levels of FIB, DD, CD3~+, CD4~+ and CD4~+/CD8~+ in the serum of the observation group were significantly higher than those in the control group, and the difference was statistically significant(P< 0.05). Conclusion Dexmedetomidine combined with Flurbiprofen Axetil has good analgesic effect and little influence on the coagulation function of the patients. It can significantly improve the immune function and improve the quality of life in patients after cholesterectomy.更多还原