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早期规范化镇痛对重型多发伤患者应激反应的影响

Influence of early analgesia by fentanyl on stress response of multiple trauma patients

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【作者】 刘明华; 文亮; 尹昌林; 屈纪富; 王娟;

【Author】 LIU Ming-hua,WEN Liang,YING Chang-lin,et al.(Southwest Hospital,Third Military Medical University,Chongqing400038,China)

【机构】 第三军医大学西南医院;

【摘要】 目的探讨早期规范化镇痛治疗对重型多发伤患者创伤应激反应的影响。方法50例重型多发伤患者,随机分为芬太尼PCA组(patient controlled analgesia)和传统疼痛处理组,在受伤后3小时内开始实施镇痛,在入院即刻、24、48小时测定血清皮质醇、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,对比分析其差异。结果两组基础值无显著差异,第24、48小时,芬太尼PCA组皮质醇、TNF-α、IL-6水平均显著低于传统疼痛处理组(P<0.05)。结论与传统疼痛处理相比较,早期规范化镇痛治疗可显著减轻创伤后应激反应。

【Abstract】 ObjectiveTo evaluate the influence of early analgesia by fentanyl on stress response of multiple trauma patients.MethodsFifty cases with severe multiple trauma were randomly divided into 2 groups: fentanyl PCA group and traditional treatment group.Analgesia was performed within 3 hours after injury,and the blood samples were obtained to determine the serum level of cortisol,TNF-α,IL-6 at 0,24,48 hours after admission.ResultsThe primary level of each item had no significant difference between 2 groups.The levels of cortisol,TNF-α and IL-6 at 24 and 48 hours in fentanyl PCA group were lower than those in traditional treatment group(P<0.05).ConclusionCompared with traditional treatment group,early analgesia by fentanyl could repress the post-traumatic stress reaction.

【关键词】 多发伤; 镇痛; 应激反应;
【Key words】 multiple trauma; analgesia; stress response;
  • 【文献出处】 创伤外科杂志 ,Journal of Traumatic Surgery , 编辑部邮箱 ,2009年01期
  • 【分类号】R641;R614
  • 【被引频次】16
  • 【下载频次】106
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