氟比洛芬酯用于全髋置换术术后镇痛及对TXA2、GPⅡb/Ⅲa表达的影响  

The effect of flurbiprofen axetil for postoperative analgesia after total hip replacement for TXA2,GP Ⅱb/Ⅲa expression

作　　者：马达[1] 王东伟[1] 杨波[1] 董文明[1] 

机构地区：[1]佳木斯大学附属第一医院,黑龙江佳木斯154003

出　　处：《黑龙江医药科学》2016年第4期38-39,41,共3页Heilongjiang Medicine and Pharmacy

基　　金：佳木斯大学研究生科技创新项目;编号:LM2015-042

摘　　要：目的：通过应用氟比洛芬酯,观察其对全髋置换患者的术后镇痛效果及对TXA2、GPⅡb/Ⅲa表达的影响。方法：选择择期进行全髋关节置换手术的患者40例,随机分为氟比洛芬酯组（A组）和地佐辛组（B组）,每组各20例。两组患者全麻诱导相同,患者入室开放静脉通道,监测血压（BP）、ECG、心率（HR）、脉搏血氧饱和度（SPO2）,分别于手术结束前30min缓慢静注氟比洛芬酯注射液（A组）50mg和地佐辛注射液（B组）5mg。术毕即刻连接PCA泵.分别于四个时间点麻醉诱导前（T1）、手术结束时（T2）、手术结束后12h（T3）24h（T4）采集外周血3m L,应用酶联免疫吸附测定（ELISA）双抗体夹心法进行测定,选取血清。测定各时间点GPⅡb/Ⅲa、和TXA2的含量,并采用疼痛视觉模拟评分（VAS）和镇静评分（Ramsay）对两种药物术后镇痛效果进行对比。采有10cm的视觉模拟量表（VAS）进行疼痛评价,0为无痛,1~3为轻度疼痛,4~6为中度疼痛,7~10为重度疼痛,10为强烈疼痛。结果：两组患者疼痛评分均无统计学意义。A组（氟比洛芬酯组）与B组（地佐辛组）TXA2、GPⅡb/Ⅲa的表达在T3和T4时刻B组的表达显著高于A组。结论：（1）氟比洛芬酯可以有效缓解全髋置换术患者术后疼痛。（2）氟比洛芬酯可以抑制血小板活化、黏附和聚集,减少深静脉血栓的形成。Objective： To observe the postoperative analgesia in patients with total hip replacement and the expression of TXA2,GP Ⅱb/Ⅲa by flurbiprofen ester throughout hip replacement patients. Methods： 40 cases with hip replacement surgery were chosen and randomly divided into flurbiprofen ester group（ group A） and to assist group（ group B）,with 20 cases in each group. Two groups of patients were generally induced by anesthesia. The patients with open vein,were monitored blood pressure（ BP）,ECG,heart rate（ HR）,pulse oxygen saturation（ SPO2）. After 30 minutes before the end of surgery,50 mg flurbiprofen were slowly injected in static note acetate into（ group A） and 5 mg into to assist injection（ group B）. PCA pump connected to patients at the end of the surgery. At four time points： before anesthesia induction（ T1）,at the end of surgery（ T2）,12 hours（ T3） 24 hours after the surgery（ T4）,peripheral blood 3 milliliter were collected. The application of enzyme linked immunosorbent assay（ ELISA） double antibody clip art are measured,and the serum was selected. The time points of GPⅡb/Ⅲa and TXA2 levels were determined. The visual analogue scale（ VAS） pain and sedation scores（ Ramsay） on postoperative analgesic effect of two drugs were compared. Mining has 10 centimeter visual analog scale（ VAS）pain assessment,0 for painless,10 to intense pain,1 ~ 3 as the degree of pain,4 ~ 6 for moderate pain,7 ~ 10 for severe pain. Results： There was no statistical significance in two groups of patients with pain score. In T3 and T4 moments,the expressions of TXA2、GPⅡb/Ⅲa in group B was significantly higher than those of group A. Conclusion：（ 1） Flurbiprofen ester can effectively alleviate the postoperative analgesia of total hip replacement patients.（ 2） Flurbiprofen ester can reduce surgical trauma caused by state of hyperalgesia and can inhibit platelet activation to reduce deep vein thrombosis.

关 键 词：氟比洛芬酯术后镇痛 全髋置换 TXA2 GPⅡb/Ⅲa 

分 类 号：R687.4[医药卫生—骨科学]