高乌甲素对直肠癌术后患者的镇痛效应和血清补体3、4水平的影响  

Effect of Lappaconitine on Postoperative Pain and Serum Complement 3 and 4 Levels of Cancer Patients Undergoing Rectum Surgery

作　　者：龚清安[1,2] 李熳[2] 

机构地区：[1]河南省南阳市中心医院麻醉科,河南473009 [2]华中科技大学同济医学院神经生物学系,武汉430030

出　　处：《中国中西医结合杂志》2015年第6期668-672,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81473768);教育部留学回国人员科研启动基金资助项目(No.2008890)

摘　　要：目的探讨直肠癌患者术后高乌甲素静脉自控镇痛(PCIA)及其对血清补体3、4(complement3、4,C3、4)水平的影响。方法选择择期行直肠癌根治术患者60例,按抽签方法平均分为对照组、曲马多组及高乌甲素组,每组20例。高乌甲素组在手术结束前30 min静脉滴注高乌甲素8 mg,30 min滴注完毕,术毕患者行PCIA,高乌甲素总用量为36 mg;曲马多组在手术结束前30 min静脉滴注曲马多100 mg,30 min滴注完毕,术毕患者行PCIA,曲马多总用量为900 mg;对照组仅术后按患者主诉需求采用肌肉注射哌替啶(50 mg/次)与氟哌利多(2.5 mg/次)予以镇痛。VAS评分测量患者术前12 h及术后12、24、48、72 h疼痛强度;同一时点采集患者外周静脉血,免疫比浊法测定血清C3、C4含量。结果对照组术后各时点VAS评分较术前高(P<0.01);曲马多组及高乌甲素组术后各时点VAS评分与术前比较,差异无统计学意义(P>0.05)。曲马多组及高乌甲素组术后各时点的VAS评分均低于对照组,差异有统计学意义(P<0.01)。曲马多组与高乌甲素组术后各时点的VAS评分差异无统计学意义(P>0.05)。3组患者术后12、24、48 h血清C3、C4水平均低于术前(P<0.05,P<0.01);至术后72 h恢复至术前水平(P>0.05)。曲马多组术后48 h,高乌甲素组术后24、48 h血清C3、C4水平较对照组同一时点升高(P<0.05)。曲马多组及高乌甲素组术后各时点的血清C3、C4水平差异无统计学意义(P>0.05)。直肠癌术后患者的VAS分值与血清C3、C4水平呈明显的负相关(r=-0.622,r=-0.649,P<0.01)。结论本研究剂量的高乌甲素用于直肠癌患者的术后镇痛有良好的效果,且能够抑制手术创伤及疼痛,并能升高C3、C4水平。Objective To explore the effect of lappaconitine on patient-controlled intravenous analgesia（PCIA） and serum complement 3 and 4（C3 and C4） levels of cancer patients undergoing rectum surgery.Methods Totally 60 patients,who were scheduled for rectum carcinoma surgery,were recruited to the study and assigned in 3 groups,the blank control group,the tramadol group,and the lappaconitine group,20 in each group.Lappaconitine（8 mg） was intravenously dripped to patients in the lappaconitine group 30 min before ending the operation.PCIA started as soon as the end of the surgery and the total dose of lappaconitine was 36 mg.Patients of the tramadol group were treated with tramadol（100 mg） intravenously within 30 min before ending the operation.The dripping was completed within30 min.PCIA was started as soon as the end of the surgery and the total dose of lappaconitine was36 mg.Tramadol（100 mg） was intravenously dripped to patients in the tramadol group 30 min before ending the operation.PICA was started as soon as the end of the surgery and the total dose of tramadol was 900 mg.Pethidine（50 mg） and droperidol（2.5 mg） was intramuscularly injected to patients in the blank control group for pain relief according to their complaints.Pain degrees were assessed by visual analog scale（VAS） 12 h before surgery,12,24,48,and 72 h after surgery.Blood samples were withdrawn at the same time point.Contents of serum C3 and C4 were determined by immunoturbidimetry.Results VAS scores of the blank control group were significantly higher after surgery than before surgery（P 〈0.01）.There was no statistical difference in VAS scores between before surgery and after surgery in the tramadol group and the lappaconitine group（P 〉0.05）.VAS scores were significantly lower at each post-surgery time point in the tramadol group and the lappaconitine group than in the blank control group with statistical difference（P 〈0.01）.There was no statistical difference in VAS scores at each post-surgery time point b

关 键 词：高乌甲素 补体3、4 患者静脉自控镇痛 疼痛 

分 类 号：R614[医药卫生—麻醉学] R735.37[医药卫生—外科学]