氟比洛芬酯镇痛对全腔镜食管癌根治术后快速康复的影响  

Postoperative administration of flurbiprofen helps rapid rehabilitation of the patient following minimally invasive esophagectomy

作　　者：杨楠[1] 王康[1] 孙磊[1] 李德闽[1] 姚圣 YANG Nan;WANG Kang;SUN Lei;LI De-min;YAO Sheng(Department of Cardiothoracic Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China;Department of Gastroenterology,Nanjing Hospital of Chinese Medical,Nanjing 210008,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)心胸外科,南京210002 [2]南京市中医院胸心血管外科,南京210008

出　　处：《医学研究生学报》2019年第7期720-723,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81702444)

摘　　要：目的全腔镜食管癌术后的疼痛是影响患者快速康复的重要因素,关于术后静脉使用氟比洛芬酯在食管癌手术后镇痛作用的研究较少。文中旨在研究氟比洛芬酯镇痛对全腔镜食管癌术后快速康复的影响。方法选取2015年10月至2016年10月东部战区总医院64例心胸外科接受全腔镜食管癌根治术患者。将患者随机分为氟比洛芬酯组(使用氟比洛芬酯+自控镇痛泵)、对照组(单纯使用自控镇痛泵),每组32例。观察2组在术后12h、24h、 48h、72h血清IL-6、降钙素原(PCT)水平,并使用静息时视觉模拟疼痛评分法(VAS评分)比较组间差异。结果氟比洛芬酯组术后12h时血清IL-6、PCT[(120.19±13.52 )μg/L、(1.89±0.18)μg/L]较对照组血清[(156.53±13.46 )μg/L、(1.99±0.12 )μg/L]明显降低(P<0.05),术后24h、48h、72h时较对照组亦明显降低(P<0.05)。氟比洛芬酯组术后12h、24h、48h、72h时VAS评分[(2.37±0.87)分、(3.84±0.92)分、(2.84±1.02)分、(2.62±0.83)分]较对照组[(4.53±1.08)分、(5.04±1.27)分、(4.00±1.05)分、(3.81±1.03)分]明显降低,差异有统计学意义(P<0.05)。结论全腔镜食管癌术后静脉使用氟比洛芬酯镇痛能显著降低术后炎症反应,缓解患者疼痛,对全腔镜食管癌手术后快速康复有重要临床意义。Objective Pain is an important factor affecting rapid rehabilitation of the patient after minimally invasive esophagectomy(MIE),and few studies are reported on the analgesic effect of intravenous administration of flurbiprofen(FBP)following MIE. This study was to investigate the role of FBP analgesia in rapid rehabilitation of the patients after MIE.Methods Sixty-four patients with esophageal cancer underwent MIE in the General Hospital of Eastern Theater Command from October 2015 to October2016. Thirty-two of them received analgesia with a patient-controlled analgesia(PCA)pump(the control group)and the other 32 with FBP plus a PCA pump(the FBP group)postoperatively. We measured the concentrations of serum interleukin 6(IL-6)and procalcitonin(PCT)at 12,24,48 and 72 hours after surgery,recorded the visual analog scale(VAS)pain scores at rest,and compared the parameters obtained between the two groups of patients.Results Compared with the control group,the FBP group showed significantly decreased concentrations of serum IL-6([156.53 ± 13.46] vs[120.19±13.52]μg/L,P < 0.05)and PCT([1.99 ± 0.12]vs[1.89 ±0.18]μg/L,P < 0.05)at 12 hours after MIE,even more significantly at 24,48 and 72 hours(P < 0.05). And the VAS scores were markedly lower in the FBP than in the control group at all the four time points(P < 0.05).Conclusion Postoperative intravenous administration of flurbiprofen can significantly reduce inflammatory reaction,relieve pain and contribute to rapid rehabilitation after minimally invasive esophagectomy.

关 键 词：氟比洛芬酯 全腔镜食管癌根治术 快速康复 

分 类 号：R735.1[医药卫生—肿瘤]