氟比洛芬酯对腹腔镜妇科手术患者内分泌及炎症反应的影响  

Effects of flurbiprofen axetil on endocrine and inflammatory responses to gynecological laparoscopic surgery

作　　者：虞雪融[1] 黄宇光[1] 杜金[2] 赵娜[3] 

机构地区：[1]中国医学科学院北京协和医院麻醉科,100730 [2]苏北人民医院麻醉科 [3]清华大学第一医院麻醉科

出　　处：《临床麻醉学杂志》2011年第12期1173-1175,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨诱导前静注氟比洛芬酯对妇科腹腔镜手术患者内分泌及炎症反应的影响。方法拟择期行妇科腹腔镜手术患者40例,随机均分为两组:氟比洛芬酯组(F组)于麻醉诱导前给予氟比洛芬酯1mg/kg,对照组(C组)给予等体积注射用脂肪乳剂。两组均采用静-吸复合麻醉。分别在给予氟比洛芬酯(或脂肪乳)前(T0)、气管插管后2min(T1)、切皮后30min(T2)、拔除气管插管后2min(T3)、手术结束后1h(T4)抽静脉血测定血糖及皮质醇浓度,并测定T0和T4时的白细胞介素(IL)-6及肿瘤坏死因子(TNF)-α水平。术后随访镇痛效果并记录住院时间。结果与T0时比较,T4时两组血糖和皮质醇浓度均显著升高(P<0.05),且C组显著高于F组(P<0.05);T4时C组IL-6、TNF-α显著升高(P<0.05),且明显高于F组(P<0.05),F组变化差异无统计学意义。F组患者在术后各时点的静息VAS评分和累计芬太尼使用量均显著低于C组(P<0.05)。结论麻醉诱导前给予氟比洛芬酯可部分抑制妇科腹腔镜手术导致的内分泌及炎症反应,并可减轻术后疼痛。Objective To investigate the effects of preoperative administration of flurbiprofen axetil （FA） on the endocrine and inflammatory responses to gynecological laparoscopic surgery. Methods Forty patients undergoing elective gynecological laparoscopic surgery were randomly assigned to one of two groups （n = 20 in each group）. Patients in group F received FA 1 m4g/kg iv before induction; whereas patients in group C received an equal volume of intralipid. All patients received combined intravenous-inhalational anesthesia. Serum glucose and cortisol levels were measured before FA administration （T0）, 2 rain after tracheal intubation （T1）, 30 rain after skin incision （T2）, 2 rain after tracheal extubation （T3） and 1 hr after surgery （T4）. Serum IL-6 and TNF-α levels were measured at To and T4. Postoperative analgesic efficacy and time to discharge were recorded. Results Serum glucose and cortisol concentrations at T4 increased in both groups compared to To （P 〈0. 05） and were higher in group C than in group F （P 〈0.05）. IL-6 and TNF-α concentrations at T4 in group C increased and were higher than those in group F （P〈0. 05）, while changes of IL-6 and TNF-α in group F were not significantly different. Postoperative VAS scores at rest and cumulative fentanyl consumption were lower in group F than in group C （P 〈 0. 05 ）. Conclusion Preoperative administration of flurbiprofen axetil could partly suppress the endocrine and inflammatory responses to gynecological laparoscopic surgery and attenuate the postoperative pain.

关 键 词：氟比洛芬酯 内分泌-代谢反应 炎症反应 妇科腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]