胆囊切除术术后持续镇痛对机体血清皮质醇的影响  

INFLUENCE OF PERSISTENT POSTOPERATIVE ANALGESIA ON SERUM CORTISOL LEVEL AFTER CHOLECYSTECTOMY

作　　者：甘春成 施镔 

机构地区：[1]青海省西宁市第三人民医院普外科

出　　处：《青海医学院学报》2013年第2期140-142,共3页Journal of Qinghai Medical College

摘　　要：目的研究胆囊切除术术后持续镇痛对机体血清皮质醇(Cor)的影响。方法选择择期手术患者30例,随机分为术后持续镇痛组(Ⅰ组)和非镇痛组(Ⅱ组),两组各15例,分别于术后2、4、8、24 h时测定Cor值,同时记录各时间点的动态VAS评分、Ramsay镇静评分及SpO2、RR。结果Ⅰ组患者各时点Cor变化无显著统计学意义,Ⅱ组在4、8、24 h时点显著升高(P<0.05),且均高于Ⅰ组(P<0.05);Ⅰ组患者各时点动态VAS评分、Ramsay镇静评分无显著统计学意义,Ⅱ组在4、8、24 h时点显著升高(P<0.05),且均高于Ⅰ组(P<0.05);Ⅰ组在各时点的RR无显著意义;Ⅱ组在4 h时点的RR显著高于2 h点(P<0.05),且高于Ⅰ组(P<0.05)。结论胆囊切除术术后持续镇痛可能通过减少血浆Cor的释放来减轻术后患者的应激反应。Objective To study the effect of persistent postoperative analgesia on cortisol level for patients with cholecystectomy. Methods 30 cases patients after cholecystectomy were randomly divided into two groups ： 15 cases were patients after cholecystectomy and received persistent postoperative analgesia（group） and the other 15 cases were patients after cholecystectomy had not received persistent postoperative analgesia（ group Ⅱ ）. The serum Corti- sol level was detected in both groups in 2,4,8, and 24 h after operation. The visual analog scale （VAS）, Ramsay scale, SpO2 and RR were recorded in every hour point mentioned above simultaneously. Result The cortisol level in group I was no statistics significant at every hour point. Group Ⅱ showed significant at 4,8 and 24 h（ P 〈 0.05 ） and higher than group I （ P 〈 0.05 ）. The RR in group I was no significant difference at every hour point; but the RR in group Ⅱ was higher at 4 h then at 2 h. Conclusion The persistent postoperative analgesia after cholecycteetomy may lighten the stress reaction by means of reducing the release of serum cortisol.

关 键 词：胆囊切除术 镇痛 血清皮质醇 影响 

分 类 号：R61[医药卫生—外科学]