中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
4期
532-534
,共3页
下肢骨折%镇痛%帕瑞昔布%患者控制%白细胞介素6%白细胞介素10
下肢骨摺%鎮痛%帕瑞昔佈%患者控製%白細胞介素6%白細胞介素10
하지골절%진통%파서석포%환자공제%백세포개소6%백세포개소10
Fracture of lower limb%Analgesia%Parecoxib%Patient controlled%Interleukin 6%Interleukin 10
目的 探讨不同镇痛方式对胫腓骨闭合性骨折患者切开复位内固定术后血中炎性因子平衡的影响.方法 将400例胫腓骨闭合性骨折患者按随机数字表法随机分为帕瑞昔布+曲马多镇痛组(P+T组)、患者自控硬膜外镇痛(PCEA)组和患者自控静脉镇痛(PCIA)组,观察3组患者术后24～48 h的疼痛视觉模拟评分(VAS评分);测定3组麻醉前、切皮后5 min、手术结束时以及术后24 ～ 48 h血浆白细胞介素6(IL-6)、IL-10比值.结果 3组术后24～48 h VAS评分差异无统计学意义(P＞0.05).3组IL-6/IL-10比值在麻醉前、切皮后5 min、手术结束各时点比较,差异无统计学意义(P＞0.05);术后24～48 h PCEA组IL-6/IL-10为(4.1±3.0),P+T组为(7.8±4.5),PCIA组为(10.9±8.6),3组间两两比较差异均有统计学意义(均P＜0.01).结论 帕瑞昔布+曲马多镇痛、PCEA、PCIA 3种镇痛方式中,PCEA对胫腓骨闭合性骨折患者切开复位内固定术后炎性因子平衡的影响最小,最有利于减轻炎症反应,其次为帕瑞昔布+曲马多镇痛.
目的 探討不同鎮痛方式對脛腓骨閉閤性骨摺患者切開複位內固定術後血中炎性因子平衡的影響.方法 將400例脛腓骨閉閤性骨摺患者按隨機數字錶法隨機分為帕瑞昔佈+麯馬多鎮痛組(P+T組)、患者自控硬膜外鎮痛(PCEA)組和患者自控靜脈鎮痛(PCIA)組,觀察3組患者術後24～48 h的疼痛視覺模擬評分(VAS評分);測定3組痳醉前、切皮後5 min、手術結束時以及術後24 ～ 48 h血漿白細胞介素6(IL-6)、IL-10比值.結果 3組術後24～48 h VAS評分差異無統計學意義(P＞0.05).3組IL-6/IL-10比值在痳醉前、切皮後5 min、手術結束各時點比較,差異無統計學意義(P＞0.05);術後24～48 h PCEA組IL-6/IL-10為(4.1±3.0),P+T組為(7.8±4.5),PCIA組為(10.9±8.6),3組間兩兩比較差異均有統計學意義(均P＜0.01).結論 帕瑞昔佈+麯馬多鎮痛、PCEA、PCIA 3種鎮痛方式中,PCEA對脛腓骨閉閤性骨摺患者切開複位內固定術後炎性因子平衡的影響最小,最有利于減輕炎癥反應,其次為帕瑞昔佈+麯馬多鎮痛.
목적 탐토불동진통방식대경비골폐합성골절환자절개복위내고정술후혈중염성인자평형적영향.방법 장400례경비골폐합성골절환자안수궤수자표법수궤분위파서석포+곡마다진통조(P+T조)、환자자공경막외진통(PCEA)조화환자자공정맥진통(PCIA)조,관찰3조환자술후24～48 h적동통시각모의평분(VAS평분);측정3조마취전、절피후5 min、수술결속시이급술후24 ～ 48 h혈장백세포개소6(IL-6)、IL-10비치.결과 3조술후24～48 h VAS평분차이무통계학의의(P＞0.05).3조IL-6/IL-10비치재마취전、절피후5 min、수술결속각시점비교,차이무통계학의의(P＞0.05);술후24～48 h PCEA조IL-6/IL-10위(4.1±3.0),P+T조위(7.8±4.5),PCIA조위(10.9±8.6),3조간량량비교차이균유통계학의의(균P＜0.01).결론 파서석포+곡마다진통、PCEA、PCIA 3충진통방식중,PCEA대경비골폐합성골절환자절개복위내고정술후염성인자평형적영향최소,최유리우감경염증반응,기차위파서석포+곡마다진통.
Objective To investigate the influence of different analgesia methods on the balance of plasma inflammatory cytokines postoperatively in patients with tibial and fibular fracture undergoing open reduction and internal fixation under lumbar epidural anesthesia.Methods Four hundred patients with tibial and fibular fracture were randomly divided into parecoxib + tramadol analgesia group(group P + T),patient controlled epidural analgesia (PCEA) group(PCEA group) and patient controlled intravenous analgesia(PCIA) group(PCIA group).Visual analogue scale(VAS) were measured 24-48 hours after operation.Venous blood samples were taken before anesthesia(T1),5 minute after skin incision(T2),at the end of operation(T3) and 24-48 hours after operation for determination of the ratio of serum interleukin-6 (IL-6) and IL-10.Results There was no statistical significance among the three groups while comparing VAS 24-48 hours after operation or the ratio of IL-6/IL-10 at T1,T2 and T3 (P ＞ 0.05).While the ratio of IL-6/IL-10 compared among the three groups 24-48 hours after operation,group PCEAwas (4.1±3.0),group P+T was (7.8 ±4.5) and PCIA group was (10.9 ±8.6) (P＜0.01).Conclusion To reduce inflammation caused by trauma and operation,PCEA is the most favorable method due to the lowest influence on the balance of plasma inflammatory cytokines while parecoxib + tramadol analgesia is the second followed by PCIA in patients with tibial and fibular fracture postoperatively.
