NF-κB在腹腔镜术后非切口疼痛中的表达及其意义  

NF-κB expression and its significance in non-incision pain after laparoscopic surgery

作　　者：陈前[1] 刘维燕[1] 江道文[1] 

机构地区：[1]上海瑞金医院集团闵行区中心医院普外科,上海201100

出　　处：《皖南医学院学报》2011年第5期377-379,共3页Journal of Wannan Medical College

基　　金：上海市闵行区科委基金项目(2008MH032)

摘　　要：目的:探讨腹腔镜CO2气腹时腹膜NF-κB表达的变化与非切口疼痛的关系。方法:通过选取手术病例,随机分为3组,每组20例:A组(腹腔镜手术);B组(乌斯他丁+腹腔镜手术);C组(开腹手术)。术中取腹膜组织,荧光定量聚合酶链反应法(荧光定量PCR)测定NF-κB mRNA表达量变化;术后采用视觉模拟评分法(VAS),观察患者手术后非切口疼痛等症状。结果:腹腔镜CO2气腹后,A组非切口疼痛发生率为75%,VAS评分6.1;B组发生率为30%,共计6例,VAS评分3.1;C组发生率为10%,共计6例,VAS评分1.7,三组有显著差异(P<0.05);NF-κB在各组均有不同程度的表达,腹腔镜CO2气腹两组(A组、B组)比开腹手术组(C组)为高(P<0.05);B组较A组表达有明显下降(P<0.05)。结论:CO2气腹后非切口疼痛与核转录因子-κB(NF-κB)高表达相关,NF-κB阻断剂(乌司他丁)在一定程度阻断NF-κB高表达,减少术后非切口疼痛发生率和程度。Objective：To investigate the relationship between change of NF-κB expression during CO2-pneumoperitoneum in laparoscopic surgery and postoperative non-incision pain.Methods： Selected surgical patients were randomized into 3 groups（n=20 for each）.Group A received conventional laparoscopic operation,group B underwent laparoscopic surgery plus inhibitor Ulinastain（UTI） and group C laparotomy.Peritoneal tissue was obtained during surgery for determination of NF-κB mRNA expression changes by fluorescence quantitative polymerase chain reaction（quantitative PCR）.Visual analogue scale（VAS） was used to estimate the non-incision pain after procedure and other symptoms.Results： After laparoscopic surgery with carbon dioxide pneumoperitoneum occurrence of non-incision pain was 75% in group A（VAS,6.1）,30% in group B（VAS,3.1） and 10% in group C（VAS1.7）,respectively.The three groups were significantly different（P0.05）.NF-κB was expressed to a certain extent in each group,and yet,it was highly expressed in both group A and B compared with group C（P0.05）.The expression in group B was lower as compared with group A（P0.05）.Conclusion： After CO2 pneumoperitoneum in laparoscopic surgery,the non-incision pain appears associated with high expression of NF-κB.Yet,NF-κB inhibitor UTI can to a certain extent effectively block the expression of NF-κB to reduce postoperative non-incision pain.

关 键 词：CO2气腹 NF-ΚB 非切口疼痛 

分 类 号：R619.9[医药卫生—外科学]