氟比洛芬酯对直肠癌根治术患者血清IL-2、IL-6表达的影响  

Effects of flurbiprofen axetil on expression of serum IL-2 and IL-6 in patients with radical resection of rectal carcinoma

作　　者：许艳淑 

机构地区：[1]上海市奉贤区奉城医院麻醉科,上海奉贤201411

出　　处：《结直肠肛门外科》2016年第1期13-17,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的重点研究氟比洛芬酯对直肠癌根治术患者血清白介素-2（IL-2）、白介素-6（IL-6）表达的影响。方法选取我院2013年10月~2015年5月肛肠外科和普外科收治的82例接受直肠癌根治术治疗的直肠癌患者。采用随机平行对照法分为对照组和观察组,两组各41例。直肠癌根治术均在硬膜外加全麻下进行,插管成功后给予丙泊酚0.1 mg/kg·min＋瑞芬太尼0.5μg/kg·min维持麻醉深度,麻醉诱导前12 min对照组静脉注射地佐辛0.1 mg/kg,观察组静脉注射氟比洛芬酯1mg/kg,术后均采用自控静脉镇痛（PCIA）。观察两组术后不同时点视觉模拟疼痛（VAS）评分和不良反应发生情况,重点检测手术围术期[麻醉前、术后6h、术后18 h、术后36 h）的血清IL-2、IL-6表达变化,常规检测两组手术前后的免疫功能T淋巴细胞亚群（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋）。结果两组均取得较好的镇痛效果,但观察组麻醉不良反应率9.76%较对照组29.27%低,差异显著（P〈0.05）;术后血清IL-2呈下降趋势,血清IL-6呈上升趋势,但观察组血清IL-2术后18 h（9.81±0.87）ng/m L、术后36 h（9.31±0.78）ng/m L分别较对照组（9.13±0.95）ng/m L、（8.64±0.84）ng/m L高,观察组血清IL-6术后18 h（73.92±7.21）pg/m L、术后36 h（55.04±8.21）pg/m L较对照组（78.81±9.24）pg/m L、（61.41±8.16）pg/m L低,均差异显著（P〈0.05）;观察组术后1周CD3＋（54.2±5.8）%、CD4＋（36.4±4.9）%分别较对照组（50.4±6.4）%、（32.8±5.1）%高,差异显著（P〈0.05）。结论对接受直肠癌根治术患者给予氟比洛芬酯注射液镇痛效果较好,安全性高,且能有效减少术后IL—2的降低和抑制IL-6的升高,缓解炎症和免疫损伤,有利于改善细胞免疫功能和预后恢复。Objective To focus on effects of flurbiprofen axetil on expression of serum interleukin-2（IL-2） and interleukin-6（IL-6） in patients with radical resection of rectal carcinoma. Methods 82 cases of patients with rectal cancer who had received radical resection of rectal carcinoma in anorectal surgical department and department of general surgery of our hospital from October 2013 to May 2015 were selected, they were divided by random parallel controlled method into the control group and the observation group（each 41 cases）. Radical resection of rectal carcinoma was performed under epidural block combined with general anesthesia, after intubation,propofol 0.1mg / Kg·min and Remifentanil 0.5μg / Kg·min were given to maintain the depth of anesthesia, 12 min before the anesthesia induction, the control group received intravenous injection of dezocine 0.1mg / Kg, the observation group received intravenous injection of flurbiprofen 1mg / Kg, all patients received patient-controlled intravenous analgesia（PCIA） after operation. The visual analogue pain scale（VAS） and adverse reaction of two groups at different time after operation were observed. Expression of IL-2 and IL-6 in serum during perioperative period [before anesthesia, 6h, 18 h, 36 h after operation] were mainly detected, immune function T lymphocyte subsets [CD3＋, CD4＋, CD8＋, CD4＋ / CD8＋] were detected by routine examination in the two groups before and after operation. Results Good analgesia effect was obtained in the two groups, but the adverse reaction rate of anesthesia in the observation group was 9.76%, which was significantly lower than the control group 29.27%（P0.05）; postoperative serum IL-2 showed a downward trend, and the serum IL-6 showed an upward trend, but in the observation group, the serum IL-2 18 h and 36 h after operation [（9.81±0.87）ng / ml,（9.31±0.78）ng / ml] were higher than those in the control group [（9.13 ±0.95）ng / ml,（8.64 ±0.84）ng / ml], 18 h after the operation, the serum IL-6 1

关 键 词：直肠癌根治术 氟比洛芬酯 镇痛 IL-2 IL-6 免疫功能 

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