中国药业
中國藥業
중국약업
CHINA PHARMACEUTICALS
2015年
1期
31-32,33
,共3页
帕瑞昔布钠%超前镇痛%应激反应
帕瑞昔佈鈉%超前鎮痛%應激反應
파서석포납%초전진통%응격반응
parecoxib sodium%preemptive analgesia%stress response
目的：观察帕瑞昔布钠超前镇痛对腹部手术患者围术期应激反应和术后镇痛的影响。方法选择美国麻醉医师协会( ASA )Ⅰ~Ⅱ级行腹部手术患者100例，随机观察组和对照组，每组50例。两组患者分别在术前30 min单次肌肉注射帕瑞昔布钠40 mg和相同容积的0.9%氯化钠注射液2 mL。两组患者分别在注射前10 min ( T1)、手术开始后30 min ( T2)、60 min ( T3)、术毕即刻( T4)及术后6 h ( T5)、12 h ( T6)抽取静脉血样，测定各时点肾上腺素( E )、去甲肾上腺素( NE )、皮质醇（Cor）、促肾上腺皮质激素（ACTH）的血浆浓度。结果与对照组比较，观察组在T2及T3时点血浆E和NE浓度显著降低( P<0.01)，在T2，T3，T4时点血浆Cor浓度显著降低( P<0.01)，在T2，T3，T 4，T5时点血浆ACTH浓度显著降低( P<0.01)。与对照组比较，观察组在术后1，2，6，12，24 h疼痛视觉模拟评分( VAS )降低( P<0.05)。结论腹部手术前预先给予帕瑞昔布钠可产生良好的超前镇痛效果，减少手术患者围术期应激激素的释放，提高术后镇痛质量，有利于术后恢复。
目的：觀察帕瑞昔佈鈉超前鎮痛對腹部手術患者圍術期應激反應和術後鎮痛的影響。方法選擇美國痳醉醫師協會( ASA )Ⅰ~Ⅱ級行腹部手術患者100例，隨機觀察組和對照組，每組50例。兩組患者分彆在術前30 min單次肌肉註射帕瑞昔佈鈉40 mg和相同容積的0.9%氯化鈉註射液2 mL。兩組患者分彆在註射前10 min ( T1)、手術開始後30 min ( T2)、60 min ( T3)、術畢即刻( T4)及術後6 h ( T5)、12 h ( T6)抽取靜脈血樣，測定各時點腎上腺素( E )、去甲腎上腺素( NE )、皮質醇（Cor）、促腎上腺皮質激素（ACTH）的血漿濃度。結果與對照組比較，觀察組在T2及T3時點血漿E和NE濃度顯著降低( P<0.01)，在T2，T3，T4時點血漿Cor濃度顯著降低( P<0.01)，在T2，T3，T 4，T5時點血漿ACTH濃度顯著降低( P<0.01)。與對照組比較，觀察組在術後1，2，6，12，24 h疼痛視覺模擬評分( VAS )降低( P<0.05)。結論腹部手術前預先給予帕瑞昔佈鈉可產生良好的超前鎮痛效果，減少手術患者圍術期應激激素的釋放，提高術後鎮痛質量，有利于術後恢複。
목적：관찰파서석포납초전진통대복부수술환자위술기응격반응화술후진통적영향。방법선택미국마취의사협회( ASA )Ⅰ~Ⅱ급행복부수술환자100례，수궤관찰조화대조조，매조50례。량조환자분별재술전30 min단차기육주사파서석포납40 mg화상동용적적0.9%록화납주사액2 mL。량조환자분별재주사전10 min ( T1)、수술개시후30 min ( T2)、60 min ( T3)、술필즉각( T4)급술후6 h ( T5)、12 h ( T6)추취정맥혈양，측정각시점신상선소( E )、거갑신상선소( NE )、피질순（Cor）、촉신상선피질격소（ACTH）적혈장농도。결과여대조조비교，관찰조재T2급T3시점혈장E화NE농도현저강저( P<0.01)，재T2，T3，T4시점혈장Cor농도현저강저( P<0.01)，재T2，T3，T 4，T5시점혈장ACTH농도현저강저( P<0.01)。여대조조비교，관찰조재술후1，2，6，12，24 h동통시각모의평분( VAS )강저( P<0.05)。결론복부수술전예선급여파서석포납가산생량호적초전진통효과，감소수술환자위술기응격격소적석방，제고술후진통질량，유리우술후회복。
Objective To investigate the effect of parecoxib sodium preemptive analgesia on the perioperative stress response and postop-erative analgesia in the patients with abdominal surgery. Methods 100 ASAI class Ⅱ cases of abdominal surgery were selected and randomly divided into two groups: the study group ( parecoxib sodium ) and the control group ( normal saline ) , 50 cases in each group. The two groups were respectively given parecoxib sodium 40 mg and the same volume of normal saline 2 mL by intramuscular in-jection at preoperative 30 min. The venous blood samples were collected for detecting the plasma concentrations of epinephrine ( E ) , norepinephrine ( NE ) , cortisol ( Cor ) , adrenocorticotropic hormone ( ACTH ) before injection of parecoxib sodium or normal saline ( T1 ) , at 30 min ( T2 ) , 60 min ( T3 ) after the operation beginning, immediately after surgery end ( T4 ) , and at postoperative 6 h ( T5 ) , 12 h ( T6 ) . Results The changes of the stress response parameters: compared with the control group, plasma E and NE concentrations at T2, T3 were significantly decreased, and the difference was statistically significant ( P<0. 01 );plasma Cor concentrations at T2, T3, and T4 were significantly decreased, and the difference was statistically significant ( P<0. 01 );plasma ACTH concentrations at T2, T3, T 4, T5 in the study group were significantly decreased compared with the control group, and the difference was statistically significant ( P<0. 01 ) . The postoperative Visual Analogue Scale ( VAS ) score results:compared with the control group, the VAS scores at postoperative 1, 6, 12, 24 h in the study group were decreased, and the differences had statistical significance ( P<0. 05 ) . Conclusion Giving parecoxib sodium in advance before abdominal operation can produce better preemptive analgesic effect, reduces the release of perioperative stress hormones, improves the quality of postoperative analgesia and conduces to postoperative rehabilitation.
