华中科技大学学报（医学版）
華中科技大學學報（醫學版）
화중과기대학학보（의학판）
ACTA UNIVERSITATIS MEDICINAE TONGJI
2014年
6期
687-691
,共5页
子宫肌瘤%帕瑞昔布钠%超前镇痛%细胞免疫
子宮肌瘤%帕瑞昔佈鈉%超前鎮痛%細胞免疫
자궁기류%파서석포납%초전진통%세포면역
uterine fibroids%parecoxib sodium%preemptive analgesia%cellular immune
目的：探讨帕瑞昔布钠超前镇痛对子宫肌瘤患者术后镇痛效果以及细胞免疫功能的影响。方法选取2011年3月至2014年4月择期行子宫肌瘤切除术患者116例，随机分为超前组（n＝58）和对照组（n＝58），麻醉前30 min ，超前组采用40 mg帕瑞昔布钠进行静脉注射，对照组采用5 mL生理盐水进行静脉注射。利用视觉模拟评分法（VAS法）对两组患者术后疼痛情况进行评价，记录两组患者 PCIA泵首次触发时间、有效按压次数和芬太尼总量。分别于术前（T0）、术后6 h（T1）、24 h（T2）、48 h（T3）和72 h（T4）采集患者静脉血，采用FACS Calibur流式细胞仪检测T淋巴细胞亚群CD3＋、CD4＋和CD8＋以及N K细胞，计算CD4＋／CD8＋。结果术后4、8、12、24和48 h ，超前组患者疼痛评分均低于对照组，差异均具有统计学意义（均 P＜0.05）；超前组患者PCIA首次触发时间晚于对照组，有效按压次数和芬太尼总量均少于对照组（均 P＜0.05）。T1、T2和T3时点，超前组CD3＋与CD4＋细胞比例均高于对照组（均 P＜0.05）；T1和 T2时点，超前组CD4＋／CD8＋均高于对照组（均 P＜0.05）；T2和T3时点，超前组NK细胞比例均高于对照组（均 P＜0.05）。结论帕瑞昔布钠超前镇痛应用于子宫肌瘤患者能够减轻患者术后疼痛，减少镇痛药用量，减轻免疫抑制，改善患者术后细胞免疫功能。
目的：探討帕瑞昔佈鈉超前鎮痛對子宮肌瘤患者術後鎮痛效果以及細胞免疫功能的影響。方法選取2011年3月至2014年4月擇期行子宮肌瘤切除術患者116例，隨機分為超前組（n＝58）和對照組（n＝58），痳醉前30 min ，超前組採用40 mg帕瑞昔佈鈉進行靜脈註射，對照組採用5 mL生理鹽水進行靜脈註射。利用視覺模擬評分法（VAS法）對兩組患者術後疼痛情況進行評價，記錄兩組患者 PCIA泵首次觸髮時間、有效按壓次數和芬太尼總量。分彆于術前（T0）、術後6 h（T1）、24 h（T2）、48 h（T3）和72 h（T4）採集患者靜脈血，採用FACS Calibur流式細胞儀檢測T淋巴細胞亞群CD3＋、CD4＋和CD8＋以及N K細胞，計算CD4＋／CD8＋。結果術後4、8、12、24和48 h ，超前組患者疼痛評分均低于對照組，差異均具有統計學意義（均 P＜0.05）；超前組患者PCIA首次觸髮時間晚于對照組，有效按壓次數和芬太尼總量均少于對照組（均 P＜0.05）。T1、T2和T3時點，超前組CD3＋與CD4＋細胞比例均高于對照組（均 P＜0.05）；T1和 T2時點，超前組CD4＋／CD8＋均高于對照組（均 P＜0.05）；T2和T3時點，超前組NK細胞比例均高于對照組（均 P＜0.05）。結論帕瑞昔佈鈉超前鎮痛應用于子宮肌瘤患者能夠減輕患者術後疼痛，減少鎮痛藥用量，減輕免疫抑製，改善患者術後細胞免疫功能。
목적：탐토파서석포납초전진통대자궁기류환자술후진통효과이급세포면역공능적영향。방법선취2011년3월지2014년4월택기행자궁기류절제술환자116례，수궤분위초전조（n＝58）화대조조（n＝58），마취전30 min ，초전조채용40 mg파서석포납진행정맥주사，대조조채용5 mL생리염수진행정맥주사。이용시각모의평분법（VAS법）대량조환자술후동통정황진행평개，기록량조환자 PCIA빙수차촉발시간、유효안압차수화분태니총량。분별우술전（T0）、술후6 h（T1）、24 h（T2）、48 h（T3）화72 h（T4）채집환자정맥혈，채용FACS Calibur류식세포의검측T림파세포아군CD3＋、CD4＋화CD8＋이급N K세포，계산CD4＋／CD8＋。결과술후4、8、12、24화48 h ，초전조환자동통평분균저우대조조，차이균구유통계학의의（균 P＜0.05）；초전조환자PCIA수차촉발시간만우대조조，유효안압차수화분태니총량균소우대조조（균 P＜0.05）。T1、T2화T3시점，초전조CD3＋여CD4＋세포비례균고우대조조（균 P＜0.05）；T1화 T2시점，초전조CD4＋／CD8＋균고우대조조（균 P＜0.05）；T2화T3시점，초전조NK세포비례균고우대조조（균 P＜0.05）。결론파서석포납초전진통응용우자궁기류환자능구감경환자술후동통，감소진통약용량，감경면역억제，개선환자술후세포면역공능。
Objective To investigate effects of parecoxib sodium preemptive analgesia on postoperative analgesia and cellu‐lar immune function in patients with uterine fibroids.Methods Totally ,116 cases of patients receiving uterine fibroids surgery were selected from March 2011 to April 2014 in our hospital.All cases were randomly divided into advanced group(n=58)and control group(n=58). The cases in the advanced group were intravenously injected with parecoxib sodium(40 mg)30 min before anesthesia ,while the control group received 5 mL saline intravenously.Postoperative pain conditions of the two groups were e‐valuated by using visual analog scale(VAS method). The PCIA pump first trigger time ,effective compression number and the total amount of fentanyl were recorded. Venous blood was collected before operation ,6 h(T1 ) ,24 h(T2 ) ,48 h(T3 )and 72 h(T4 ) after operation ,respectively. T lymphocyte subsets of CD3+ ,CD4+ and CD8+ and NK cells were detected by using FACS Cali‐bur flow cytometer.The ratio of CD4+ /CD8+ was calculated.Results After 4 ,8 ,12 ,24 and 48 h ,the pain scores of patients were significantly lower in the advanced group than in the control group(all P<0.05). The PCIA pump first trigger time was longer ,effective compression number and the total amount of fentanyl of patients were less in the advanced group than in the control group ,the differences were statistically significant(all P<0.05). At T1 ,T2 and T3 ,CD3+ and CD4+ were significantly higher in the advanced group than in the control group(P<0.05).At T1 and T2 ,CD4+ /CD8+ was significantly higher in the advanced group than in the control group(both P<0.05).At T2 and T3 ,the NK was significantly higher in the advanced group than in the control group(both P<0.05).Conclusion Parecoxib sodium preemptive analgesia used in patients with uterine fi‐broids can reduce postoperative pain ,reduce the amount of analgesics ,reduce the immune suppression ,and improve immune function in patients after surgery.
