作　　者： (宋平）; (王飞）;

机构地区： 四川省眉山市人民医院麻醉科,四川眉山620010

出　　处： 《海南医学院学报》 2017年第13期1822-1825,共4页

摘　　要： 目的:探讨腹腔镜肝癌切除术后地佐辛联合舒芬太尼方案自控静脉镇痛对全身疼痛及炎症介质的影响。方法:收集在本院接受腹腔镜手术治疗的原发性肝癌患者68例,回顾治疗方案并分为接受舒芬太尼PCIA的对照组35例、接受地佐辛联合舒芬太尼方案PCIA的观察组33例。对比两组手术前后血清中疼痛介质、急性时相蛋白、白介素含量的差异。结果:术前,两组血清中疼痛介质、急性时相蛋白、白介素含量的差异无统计学意义(P>0.05)。术后6h,观察组血清中疼痛介质SP、NPY、DA、NE的含量低于对照组;急性时相蛋白CRP、HP、CER、AAG的含量低于对照组;白介素IL-1β、IL-6、IL-8的含量低于对照组(P<0.05)。结论:腹腔镜肝癌切除术后地佐辛联合舒芬太尼方案PCIA,可有效降低术后早期疼痛介质含量并缓解全身炎症反应。 Objective：To study the effect of dezocine combined with sufentanil patient-controlled intravenous analgesia on general pain and inflammatory mediators after laparoscopic hepatectomy.Methods：A total of 68 patients with primary liver cancer who received laparoscopic surgical treatment in our hospital were collected,the therapies were reviewed,and then patients were divided into the control group（n=35）who received sufentanil PCIA and the observation group（n=33）who received dezocine combined with sufentanil PCIA.Differences in serum levels of pain mediators,acute phase proteins and interleukins were compared between the two groups of patients before and after operation.Results：Before operation,the differences in serum levels of pain mediators,acute phase proteins and interleukins were not statistically significant between the two groups of patients（P〉0.05）.Six hours after operation,serum pain mediators SP,NPY,DA and NE levels in observation group were lower than those in control group;acute phase proteins CRP,HP,CER and AAG levels were lower than those in control group;interleukins IL-1β,IL-6and IL-8levels were lower than those in control group（P〈0.05）.Conclusion：Dezocine combined with sufentanil PCIA after laparoscopic hepatectomy is effective in reducing the early postoperative pain mediator levels and relieving systemic inflammatory response.

关 键 词： 肝癌 地佐辛 舒芬太尼 疼痛 炎症介质