腹腔镜子宫肌瘤切除术术后行舒芬太尼靶控镇痛的效果及对患者应激反应、免疫功能的影响

doi:10.3969/j.issn.1671-7171.2020.05.022

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摘要 【目的】 探讨腹腔镜子宫肌瘤切除术术后患者行舒芬太尼靶控镇痛的效果及对术后应激反应、免疫功能的影响。【方法】 本院行腹腔镜手术患者82例,随机分为对照组(n=42)和观察组(n=40),对照组术后使用静脉途径镇痛,观察组使用枸橼酸舒芬太尼靶控镇痛。比较术后两组患者镇静、镇痛评分情况以及治疗前后P物质和β内啡肽浓度和CD4⁺、CD8⁺、CD4⁺/CD8⁺水平差异。【结果】 术后两组患者镇痛和镇静评分相比较差异均有显著性(P<0.05)。治疗后观察组的P物质浓度水平显著低于,内啡肽浓度水平显著高于治疗前和同期对照组,且差异具有显著性(P<0.05)。治疗后观察组的CD4⁺ 水平显著低于治疗前和同期对照组(P<0.05),治疗后两组间的CD8⁺ 和CD4⁺/CD8⁺水平相比较差异无显著性(P>0.05)。【结论】 腹腔镜子宫肌瘤切除术术后患者行舒芬太尼靶控镇痛,其镇痛和镇静效果好于静脉输注组,且可降低患者的术后应激反应和调节免疫功能,值得临床上进一步推广。

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	廖海明
	余凡
	邓庆珊
	廖家齐

关键词 ：腹腔镜检查, 舒芬太尼/治疗应用, 镇痛

Abstract：【Objective】 To investigate the effect of sufentanil target-controlled infusion on postoperative analgesia, stress response and immune function after laparoscopic surgery. 【Methods】 A total of 82 patients with laparoscopic surgeries in our hospital were collected in the study. The randomized digital table was used to divide these cases into the control group (n=42) and the observation group (n=40). Patients in the control group received intravenous analgesia after operation, while patients in the observation group received the target-controlled analgesic of citrate sufentanil after operation. The postoperative sedation and analgesia scores of the two groups were compared, meanwhile, the concentrations of substance P and β endorphin and levels of CD4⁺, CD8⁺, CD4⁺/CD8⁺ were measured before and after treatment.【Results】 The analgesia and sedation scores between the two groups had significant difference (P<0.05). After treatment, the level of substance P in the observation group was significantly lower, while the level of β-endorphin in the observation group was higher than that in the control group and before treatment (P<0.05). The level of CD4⁺ in observation group after treatment was lower than that before treatment, and the CD4⁺ level in the observation group was also lower than that in the control group (P<0.05). The levels of CD8⁺ and CD4⁺/CD8⁺ had no significant difference between the two groups (P>0.05). 【Conclusion】 The application of the sufentanil target-controlled infusion shows good postoperative analgesia effect, which reduces the postoperative stress response and immune function regulation for patients after laparoscopic surgery. It is worthy of further clinical promotion.

Key words： Lapa-roscopy Sufentanil/TU Analgesia

收稿日期: 2018-10-25

PACS:

R61

引用本文:

廖海明, 余凡, 邓庆珊, 廖家齐. 腹腔镜子宫肌瘤切除术术后行舒芬太尼靶控镇痛的效果及对患者应激反应、免疫功能的影响[J]. 医学临床研究, 2020, 37(5): 708-711.
LIAO Hai-ming, YU Fan, DENG Qing-shan, et al. Effect of Sufentanil Target-Controlled Infusion on Postoperative Analgesia, Stress Response and Immune Function after Laparoscopic Surgery. JOURNAL OF CLINICAL RESEARCH, 2020, 37(5): 708-711.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.05.022 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I5/708