氟比洛芬酯联合七叶皂苷钠对阻塞性睡眠呼吸暂停低通气综合征多平面术后镇痛效果  

Analgesic Effects of Flurbiprofen Axetil Combined with Sodium Aescinate after Multiplanar Joint Surgery for Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：苏静[1] 梅文华[1] 刘玲玲 田君海[1] 董凯峰[1] 李丹[1] 段立广[2] SU Jing;MEI Wen-hua;LIU Ling-ling;TIAN Jun-hai;DONG Kai-feng;LI Dan;DUAN Li-guang(Department of Otolaryngology,the First Hospital of Hebei Medical University, Shijiazhuang 050031, China;Pharmacy Department, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China)

机构地区：[1]河北医科大学第一医院耳鼻喉科,石家庄050031 [2]河北医科大学第一医院药学部,石家庄050031

出　　处：《临床误诊误治》2018年第12期32-36,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点科技研究计划课题(20170495)

摘　　要：目的观察氟比洛芬酯联合七叶皂苷钠对阻塞性睡眠呼吸暂停低通气综合征多平面术后镇痛效果。方法选取我院收治的行多平面手术的重度OSAHS 90例,按照随机数字表法分为对照组、氟比洛芬酯组与氟比洛芬酯联合七叶皂苷钠组(联合用药组),每组各30例。对照组术后12 h口服氨酚羟考酮5 mg、3/d,连用3 d;氟比洛芬酯组与联合用药组均于术前30 min、术后12、24、36、48、60、72 h静脉注射氟比洛芬酯50 mg,在此基础上,联合用药组术后3 d静脉滴注七叶皂苷钠10 mg/d,治疗3 d。记录术后24、36、48、72、96 h视觉模拟评分(visual analog scale,VAS),检测术前0. 5 h、术后24 h白细胞介素(Interleukin,IL)-2、IL-6水平变化,观察呼吸暂停低通气指数(apnea-hypopnea index,AHI)、术中出血量、手术时间及不良反应发生情况。结果与对照组比较,氟比洛芬酯组、联合用药组术后24、36、48、72、96 h VAS评分均明显降低,差异有统计学意义(P <0. 05);与氟比洛芬酯组比较,联合用药组术后24、36、48、72、96 h VAS评分下降,差异有统计学意义(P <0. 05)。与对照组比较,氟比洛芬酯组、联合用药组术后24 h IL-2水平升高,IL-6水平降低,差异有统计学意义(P <0. 05);与氟比洛芬酯组比较,联合用药组术后24 h IL-2水平升高,IL-6水平下降,差异有统计学意义(P <0. 05)。三组AHI、术中出血量、手术时间、不良反应发生率比较差异无统计学意义(P>0. 05)。结论氟比洛芬酯联合七叶皂苷钠对重度OSAHS多平面术后镇痛效果肯定,临床可推广应用。Objective To observe the analgesic effects of flurbiprofen axetil combined with sodium aescinate after multi-planar joint surgery for obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of90cases of severe OSAHS who underwent multi-planar joint surgery in our hospital were selected and divided into control group(n=30),flurbiprofen axetil group(n=30)and flurbiprofen axetil combined with heptasaponin sodium group(combination group;n=30)according to the random number table method.The control group received oral oxycodone tablets5mg,3/d12h after operation for3d;flurbiprofen axetil group and combination group were treated with intravenous injection of flurbiprofen50mg30min before surgery,and at12h,24h,36h,48h and60h,72h postoperatively.On this basis,the combination group was given intravenous infusion of sodium aescinate10mg/d for3d after surgery.The course of treatment was3d.The visual analog scale(VAS)was recorded at24h,36h,48h,72h,and96h after surgery.The levels of interleukin(IL)-2and IL-6were measured30min before surgery and24h after surgery.The apnea-hypopnea index(AHI),intraoperative blood loss,duration of operation and adverse reactions were recorded.Results Compared with the control group,the VAS scores of the flurbiprofen axetil group and combination group at24h,36h,48h,72h and96h after surgery were significantly reduced,and the difference was statistically significant(P<0.05).Compared with flurbiprofen axetil group,the VAS score was decreased at24h,36h,48h,72h and96h after surgery in combination group with a statistically significant difference(P<0.05).As compared with the control group,24-h IL-2was increased while the IL-6was decreased in flurbiprofen axetil group and combination group,and the difference was statistically significant(P<0.05).As compared with flurbiprofen axetil group,24-h IL-2was increased while the IL-6were decreased in combination group,suggesting significant differences(P<0.05).There was no significant difference between the three groups in terms of AHI,intraoperative blood

关 键 词：睡眠呼吸暂停 阻塞性 外科手术 镇痛 氟比洛芬酯 七叶皂苷钠 

分 类 号：R563.8[医药卫生—呼吸系统]