舒芬太尼复合地佐辛镇痛对中老年胸科手术后胰岛素抵抗及促炎细胞因子的影响  

Influence of Sufentanil Combined with Dezocine Analgesia on Insulin Resistance and Proinflammatory Cytokines after Elderly Thoracic Surgery

作　　者：陆荣臻[1] 黄泽汉[1] 李天资[2] 黄锦益[1] 韦忠良[1] 李琳[1] 

机构地区：[1]右江民族医学院附属医院麻醉科,广西百色533000 [2]右江民族医学院附属医院心研所,广西百色533000

出　　处：《现代生物医学进展》2015年第24期4706-4709,共4页Progress in Modern Biomedicine

基　　金：广西百色市科学研究与技术开发计划项目(百科计20110515)

摘　　要：目的:研究舒芬太尼复合地佐辛镇痛对中老年胸科手术后胰岛素抵抗及促炎细胞因子的影响。方法:选取2012年12月到2014年12月我院收治的中老年胸科手术患者80例,按照随机数字表法将患者分为研究组和对照组,每组40例。研究组给予舒芬太尼复合地佐辛镇痛,对照组给予舒芬太尼镇痛,比较两组术后2 h和24 h视觉模拟评分(VAS)和镇静程度评分(Ramsay),比较手术前、术后2 h和24 h两组胰岛素含量、胰岛素敏感性以及肿瘤坏死因子-a(TNF-a)、白介素-6(IL-6)情况。结果:术后2 h和24 h研究组VAS评分均显著低于对照组,Ramsay评分显著高于对照组,两组比较差异具有统计学意义(P<0.05);两组术后2 h和24 h胰岛素含量、胰岛素敏感性比较差异具有统计学意义(P<0.05);手术前两组TNF-a、IL-6水平比较均无统计学意义(P>0.05),术后2 h和24 h研究组TNF-a、IL-6显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论:舒芬太尼复合地佐辛应用于中老年胸科手术具有较好的术后镇痛效果,且具有抑制胰岛素抵抗和促炎细胞因子的作用。Objective： To study the influence of sufentanil combined with dezocine analgesia on insulin resistance and proinflammatory cytokines after elderly thoracic surgery. Methods： A total of 80 elderly patients, who underwent thoracic surgery in Affiliated Hospital of Youjiang Medical College For Nationalities from December 2012 to December 2014, were selected and randomly divided into study group（n=40） and control group a（n=40）. The study group was treated with sufentanil combined with dezocine analgesia, while the control group, sufentanil analgesia. The visual analog scale（VAS） score and Ramsay score of the two groups 2 h and 24 h after surgery and the insulin levels, insulin sensitivity, TNF-a and IL-6 of the two groups before surgery, 2 h and 24 h after surgery were compared. Results： VAS scores in the study group 2h and 24 h after surgery were significantly lower than those in the control group, but Ramsay scores were significantly higher than control group, the differences were statistically significant（P〈0.05）. There was statistical significance in insulin level and insulin sensitivity between the two groups 2 h and 24 h after surgery（P〈0.05）. There was no statistical significance in TNF-a and IL-6 levels between the two groups before surgery（P〉0.05）, but the TNF-a and IL-6 levels of the study group were significantly lower than those in the control group 2h and 24 h after surgery（P〈0.05）, the differences were statistically significant（P〈0.05）. Conclusion：Sufentanil combined with dezocine has a better analgesia effect on the elderly patients after thoracic surgery, and it can inhibit the insulin resistance and proinflammatory cytokines.

关 键 词：舒芬太尼 地佐辛 镇痛 胰岛素抵抗 促炎细胞因子 

分 类 号：R614[医药卫生—麻醉学]