地佐辛超前镇痛对腹腔镜手术患者血清炎性因子和自由氧因子的影响

杨伟才 吴丹丹 莫海龙

【摘要】 目的：分析地佐辛对腹腔镜手术患者的超前镇痛作用及对血清炎性因子（TNF-α、IL-6）、自由氧因子（MDA、SOD）、术后镇痛效果的影响。方法：选取2016年6月-2018年5月本院84例行腹腔镜手术患者，按照随机数字表法将其分为观察组与对照组，每组各42例。观察组予以地佐辛进行超前镇痛，对照组注射等量生理盐水。比较两组手术前后血清炎性因子和自由氧因子水平、术后镇痛情况。结果：术后48 h，观察组TNF-α、IL-6均低于对照组（P<0.05）;术后48 h，观察组MDA低于对照组，SOD高于对照组，差异均有统计学意义（P<0.05）;观察组术后2、12、24 h镇痛评分均低于对照组，差异均有统计学意义（P<0.05）。结论：患者进行腹腔镜手术时，应用地佐辛复超前镇痛可以调节自由氧因子和血清炎症因子水平，从而进行超前镇痛，且术后镇痛效果较好。

【关键词】 地佐辛; 腹腔镜手术; 超前镇痛; 血清炎性因子; 自由氧因子

【Abstract】 Objective：To analyze the preemptive analgesic effect of Dezocine on patients undergoing laparoscopic surgery and its effects on serum inflammatory factors（TNF-α，IL-6），free oxygen factors（MDA，SOD）and postoperative analgesia.Method：A total of 84 patients undergoing laparoscopic surgery in our hospital from June 2016 to May 2018 were selected.According to the random number table method，they were divided into observation group and control group，42 cases in each group.The observation group was given preemptive analgesia with Dezocine，while control group was injected with the same amount of Normal Saline.The levels of serum inflammatory factors and free oxygen factors before and after operation，and postoperative analgesia between two groups were compared.Result：At 48 hours after operation，the TNF-α and IL-6 in observation group were lower than those of control group（P<0.05）.At 48 hours after operation，the MDA in observation group was lower than that of control group，SOD was higher than that of control group，the differences were statistically significant（P<0.05）.The analgesic scores of observation group at 2，12 and 24 hours after operation were lower than those of control group，the differences were statistically significant（P<0.05）.Conclusion：When patients undergoing laparoscopic surgery，preemptive analgesia with Dezocine can regulate the levels of free oxygen factors and serum inflammatory factors，so as to carry out preemptive analgesia，and the effect of postoperative analgesia is better.

【Key words】 Dezocine; Laparoscopic surgery; Preemptive analgesia; Serum inflammatory factor;Free oxygen factor

First-authors address：Lianjiang Peoples Hospital，Lianjiang 524400，China

doi：10.3969/j.issn.1674-4985.2019.16.014

腹腔鏡手术作为开放性手术的取代方法，具有创口小、损伤小、住院天数短等优点，但是手术仍会给患者带来剧烈的疼痛的感觉[1-2]。超前镇痛（preemptive analgesia）指在机体受到伤害性刺激作用之前就采取一些消除伤害性刺激作用传入的措施，阻碍外周或中枢神经敏化，减轻伤害引起的疼痛[3-5]。超前镇痛的时程不仅包括手术前，手术中及手术后的早期阶段也可为超前镇痛的给药时间[6-8]。地佐辛作为一种阿片受体激动-拮抗剂，可应用于腹腔镜手术患者的超前麻醉，本院研究地佐辛的超前镇痛作用及对血清炎性因子、自由氧因子及术后镇痛效果的影响，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年6月-2018年5月本院84例行腹腔镜手术患者。（1）纳入标准：自愿配合研究中的观察和随访;经心电图诊断心功能正常者;无阿片类药物使用史;近期无进行麻醉手术史者。（2）排除标准：有严重精神疾病者;对本研究使用的药物过敏或不能使用阿片类药物者;有严重肝肾功能障碍者。……