CAJ | 학술논문

目的：研究盐酸氢吗啡酮术后镇痛对全髋置换术患者的炎性细胞因子水平和血液流变学的影响。方法将100例全髋置换术患者随机分为两组。对照组50例患者，给予患者舒芬太尼术后镇痛。观察组50例患者，给予患者盐酸氢吗啡酮术后镇痛。比较两组患者血液流变学（红细胞、血浆黏度、全血黏度、全血还原黏度）与炎性细胞因子水平（CRP、IL-1、TNF-α、IL-6）。结果观察组与对照组在治疗前的血液流变学、炎性细胞因子水平相比较无统计学意义（P>0.05）。治疗后1d以及5d，观察组的红细胞的聚集指数、电泳指数、刚性指数，血浆黏度，全血黏度、全血还原黏度均低于对照组，两者相比有统计学差异(P<0.05）。治疗后1d以及5d，观察组的炎性细胞因子水平（CRP、IL-1、TNF-α、IL-6）均低于对照组，两者相比有统计学差异(P<0.05）。结论盐酸氢吗啡酮能够使全髋置换术患者的血液流变学更加稳定，并能明显降低患者的炎性细胞因子水平，减弱炎症反应，值得临床推广。
목적：연구염산경마배동술후진통대전관치환술환자적염성세포인자수평화혈액류변학적영향。방법장100례전관치환술환자수궤분위량조。대조조50례환자，급여환자서분태니술후진통。관찰조50례환자，급여환자염산경마배동술후진통。비교량조환자혈액류변학（홍세포、혈장점도、전혈점도、전혈환원점도）여염성세포인자수평（CRP、IL-1、TNF-α、IL-6）。결과관찰조여대조조재치료전적혈액류변학、염성세포인자수평상비교무통계학의의（P>0.05）。치료후1d이급5d，관찰조적홍세포적취집지수、전영지수、강성지수，혈장점도，전혈점도、전혈환원점도균저우대조조，량자상비유통계학차이(P<0.05）。치료후1d이급5d，관찰조적염성세포인자수평（CRP、IL-1、TNF-α、IL-6）균저우대조조，량자상비유통계학차이(P<0.05）。결론염산경마배동능구사전관치환술환자적혈액류변학경가은정，병능명현강저환자적염성세포인자수평，감약염증반응，치득림상추엄。
Objective To study the effect of inflammatory cytokines and hemorheology in patients with total hip arthroplasty treated by hydromorphone hydrochloride. Methods 100 patients associated with total hip arthroplasty were divided randomly into observation and control groups. 50 patients in the observation group,they were treated by using hydromorphone hydrochloride. 50 patients in the control group,with sulfentanyl treated. Blood rheology(red blood cells,plasma viscosity,whole blood viscosity,whole blood reduced viscosity) and inflammatory cytokine levels (CRP,IL-1,TNF-α,IL-6)were compared with each other. Results Be-fore treatment,hemorrheology,inflammatory cytokine levels of in the observation group and control group had no significant (P>0. 05). After treatment 1d and 5d,erythrocyte aggregation index,electrophoresis index,rigidity index,plasma viscosity,whole blood viscosity,whole blood reduced viscosity of the observation group were lower than the control group,there were statistically signifi-cant(P<0.05). After 1d and 5d’treatment,levels of inflammatory cytokines (CRP,IL-1,TNF-α,IL-6) of the observation group were lower than the control group,there were significant differences (P<0.05). Conclusion Hydromorphone hydrochloride could have a more stable hemorheology for patients with total hip arthroplasty. Hydromorphone hydrochloride can significantly reduce the in-flammatory cytokine levels and decrease inflammation. It is worthy of promotion in clinic.