盐酸氢吗啡酮联合罗哌卡因用于等离子前列腺电切术后PCEA对疼痛介质及应激反应的影响  

Effect of hydromorphone hydrochloride combined with ropivacaine for PCEA after transurethral resection of prostate on pain mediators and stress response

作　　者：马玉林[1] 龚勇娟 李玲[1] 石磊[1] 

机构地区：[1]陕西省安康市中心医院麻醉科,陕西安康725000

出　　处：《海南医学院学报》2017年第15期2090-2093,共4页Journal of Hainan Medical University

基　　金：陕西省科学技术研究发展计划(2012K14-09-12)

摘　　要：目的:研究盐酸氢吗啡酮联合罗哌卡因用于等离子前列腺电切术后自控硬膜外镇痛(PCEA)对疼痛介质及应激反应的影响。方法:选择在本院接受等离子前列腺电切术的138例患者,随机分为A、B两组,A组患者术后给予盐酸氢吗啡酮联合罗哌卡因PCEA、B组患者术后给予盐酸吗啡联合罗哌卡因PCEA。手术前及手术后12、24、48h,检测两组患者血清中疼痛介质、炎症反应细胞因子、应激激素的含量。结果:手术后12、24、48h,两组血清中SP、BK、HIS、CX3CL1、CCL2、IL-1β、TNF-α、IL-10、ACTH、CORT、TSH、FT3、FT4、GH的含量均显著高于手术前(P<0.05)且A组患者血清中SP、BK、HIS、CX3CL1、CCL2、IL-1β、TNF-α、IL-10、ACTH、CORT、TSH、FT3、FT4、GH的含量均显著低于B组(P<0.05)。结论:盐酸氢吗啡酮联合罗哌卡因PCEA能够较盐酸吗啡联合罗哌卡因PCEA更为有效的减轻等离子前列腺电切术后的疼痛及应激。Objective： To study the effect of hydromorphone hydrochloride combined with ropivacaine for patient-controlled epidural analgesia （PCEA） after transurethral resection of prostate on pain mediators and stress response. Methods： A total of 138 patients who received transurethral resection of prostate in Ankang Central Hospital were selected and randomly divided into group A and group B, group A received postoperative hydromorphone hydrochloride combined with ropivacaine for PCEA, and group B received postoperative morphine hydrochloride combined with ropivacaine for PCEA. The serum contents of pain mediators, inflammatory response eytokines and stress hormones of the two groups were detected before surgery as well as 12, 24 and 48 h after surgery. Results： Twelve, twenty-four and forty-eight h after surgery, serum SP, BK, HIS, CX3CL1, CCL2, IL-1β, TNF-α, IL-10, ACT H, CORT, TSH, FT3, FT4 and G H levels of both groups of patients were sig- nificantly higher than those before surgery （P〈0.05）, and serum SP, BK, HIS, CX3CL1, CCL2, IL-1β, TNF-α, IL-10, ACTH, CORT, TSH, FT3, FT4 and GH levels of group A were significantly lower than those of group B （P〈0.05）. Con- clusions： Hydromorphone hydrochloride combined with ropivacaine for PCEA can more effectively reduce the pain and stress after trsurethral resection of prostate than morphine hydrochloride combined with ropivacaine for PCEA.

关 键 词：等离子前列腺电切术 自控硬膜外镇痛 疼痛介质 应激激素 炎症反应 

分 类 号：R697.3[医药卫生—泌尿科学]