帕瑞昔布钠对肝癌射频消融术患者全身炎性反应的影响  

Effects of parecoxib on inflammatory response in patients after radio-frequency ablation for liver cancer

作　　者：吕帅国[1] 李长生[1] 李廷坤[1] 汪蕾[1] 孙亚林[1] 卢锡华[1] 

机构地区：[1]河南省肿瘤医院麻醉科,郑州450003

出　　处：《中国实用医刊》2015年第1期24-25,共2页Chinese Journal of Practical Medicine

摘　　要：目的 评价帕瑞昔布钠对CT引导下经皮肝癌射频消融术患者术后炎性反应的影响.方法 择期行CT引导下经皮肝癌射频消融术的患者40例,性别不限,年龄45～68岁,体质量48 ～75 kg,ASA分级Ⅱ或Ⅲ级,肝功能Child-Pugh分级A级,采用随机数字表法将患者分为对照组（C组）和帕瑞昔布钠组（P组）,每组20例.麻醉诱导：静脉注射异丙酚1～2 mg/kg和芬太尼2～4 μg/kg,插入喉罩后行机械通气.麻醉维持：吸入2％七氟醚,靶控输注瑞芬太尼,血浆靶浓度4 μg/L.术中维持BIS值45 ～60.P组于手术开始时静脉注射帕瑞昔布钠40 mg,C组给予等容量氯化钠注射液.分别于麻醉前、术后2h、24h和48 h时抽取上肢静脉血样,测定血浆肿瘤坏死因子-α（TNF-α）和白细胞介素-8（IL-8）的浓度.结果 与C组比较,P组术后2h、24 h和48 h时血浆TNF-α和IL-8的浓度降低（P＜0.05）.结论 帕瑞昔布钠可降低CT引导下经皮肝癌射频消融患者术后全身炎性反应。Objective To investigate the effects of parecoxib on inflammatory response in patients after CT-guided percutaneous radio-frequency ablation （RFA） for liver cancer.Methods Forty ASA Ⅱ or Ⅲ and Child-Pugh A patients of both sexes aged 45-68 years old,weighing 48-75 kg,undergoing CT-guided percutaneous radio-frequency ablation for liver cancer,were randomly divided into two groups （n =20 each）：control group （group C） and parecoxib group （group P）.Anesthesia was induced with propofol 1-2 mg/kg and fentanyl 2-4 pg/kg and maintained with inhalation of 2% sevoflurane and TCI remifentanil（Cp 4μg/L）.Laryngeal mask airway was inserted,and the patients were mechanically ventilated.BIS value was maintained at 45-60.Blood samples were taken from veins of upper limb before surgery（T0） and at 2 h,24 h and 48 h after surgery（T1-3） for determination of plasma TNF-αand IL-8 concentrations.Results Compared with group C,plasma concentrations of TNF-α and IL-8 were significantly decreased at 2 h,24 h and 48 h after operation in group P（P 〈0.05）.Conclusions Parecoxib can reduce the inflammatory response after CT-guided percutaneous radio-frequency ablation for liver cancer.

关 键 词：帕瑞昔布钠 炎症 导管消融术 肝肿瘤 

分 类 号：R927.2[医药卫生—药学]