舒芬太尼复合地佐辛麻醉对腹腔镜胃癌切除患者血清炎性因子和早期认知功能的影响  

Influence of Sufentanil Combined with Dezocine on the Inflammatory Factors Levels and Early Cognitive Function of Patients Underwent Laparoscopic Gastric Cancer Resection

作　　者：卢林[1] 张涛[1] 史红萍[1] 张丽梅[2] 李红军[2] LU Lin ZHANG Tao SHI Hong-ping ZHANG Li-mei LI Hong-jun(Department of anesthesia, Central Hospital of Chongqing Three Gorges, Chongqing, 404000, China Department ofanesthesia, Affiliated Hospital ofChengdu University of Traditional Chinese Medicine, Sichuan, Chengdu, 610075, China)

机构地区：[1]重庆三峡中心医院麻醉科,重庆404000 [2]成都中医药大学附属医院麻醉科,四川成都610075

出　　处：《现代生物医学进展》2017年第11期2099-2101,2098,共4页Progress in Modern Biomedicine

基　　金：四川省卫生厅科研课题(1105912)

摘　　要：目的:研究舒芬太尼复合地佐辛对腹腔镜胃癌切除患者术后炎性因子、早期认知功能的影响。方法:选取2015年4月至2016年3月本院收治的84例胃癌患者,根据入院顺序分为观察组和对照组,每组42例。对照组采取单纯舒芬太尼术后镇痛,观察组使用舒芬太尼符合地佐辛术后镇痛。比较两组患者术前、术后的视觉模拟评分(VAS)、炎性因子水平和认知功能评分变化。结果:两组患者术后6、12、24、48小时VAS均较术前呈下降趋势,观察组在术后6、12、24、48 h VAS均显著低于对照组(P<0.05)。术后7天,观察组患者血清IL-6、TNF-α水平显著低于对照组,IL-10水平显著高于对照组,差异均有统计学意义(P<0.05)。观察组患者的认知功能评分(80.43±1.32)显著高于对照组(66.54±1.56)(P<0.05)。观察组和对照组的不良反应发生率比较无统计学差异[14.29%(6/42)比19.05%(8/42)](P>0.05)。结论:腹腔镜胃癌切除患者应用舒芬太尼复合地佐辛术后镇痛可有效缓解患者术后疼痛感,调节术后炎性因子水平,改善早期认知功能障碍,且安全性较高。Objective： To investigate the effect of sufentanil combined with docetaxel on inflammatory factors and early cognitive function in patients undergoing laparoscopic resection of gastric cancer. Methods： 84 patients with gastric cancer admitted to our hospital from April 2015 to March 2016 were divided into the observation group and the control group. Patients in the control group were treated with sufentanil and patients in the observation group were treated with sufentanil combined with docetaxel. The visual analogue scale （VAS）, changes of inflammatory factors before and after operation, and the postoperative cognitive function scores were compared be- tween the two groups. Results： The VAS of both groups was decreased at 6, 12, 24 and 48 h after operation, and the VAS of observation group was lower than that of the control group at 6,12, 24 and 48 h after operation （P〈0.05）. At 7 days ailer operation, the levels of IL-6 and TNF-a in the observation group were significantly lower than those of the control group, the level of IL-10 was significantly higher than that of the control group （P〈0.05）. The cognitive function score of observation group （80.43± 1.32） was significantly higher than that of the control group （66.543± 1.56） （P〈0.05）. There was no statistically significant difference in the incidence of adverse reactions be- tween two groups [14.29% （6/42） vs 19.05% （8/42）] （P〉0.05）. Conclusion： Laparoscopic resection of gastric cancer patients with sufan- tanil combined with dezocine after analgesia could relieve the postoperative pain, adjust the level of inflammatory factors after surgery, improve the early cognitive dysfunction, and have fewer adverse reactions.

关 键 词：舒芬太尼 地佐辛 腹腔镜胃癌切除术 炎性因子 认知功能 

分 类 号：R735.2[医药卫生—肿瘤] R614[医药卫生—临床医学]