帕瑞昔布钠对幕上颅脑肿瘤术后脑水肿和炎症反应的影响  

The effect of parecoxib sodium on cerebral edema and inflammatory response after supratentorial brain tumor surgery

作　　者：史树海 张云馨 程景丽[2] 孙永兴 王保国[3] SHI Shuhai;ZHANG Yunxin;CHENG Jingli;SUN Yongxing;WANG Baoguo(Intensive Care Unit,Sanbo Brain Hospital Capital Medical University,Beijing 100093,China;Department of Neurosurgery,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Inner Mongolia,Baotou 014010,China;Department of Anesthesiology,Sanbo Brain Hospital Capital Medical University,Beijing 100093,China)

机构地区：[1]首都医科大学三博脑科医院重症医学科,北京100093 [2]内蒙古科技大学包头医学院第一附属医院神经外科,内蒙古包头014010 [3]首都医科大学三博脑科医院麻醉科,北京100093

出　　处：《中国医药科学》2020年第12期1-5,10,共6页China Medicine And Pharmacy

基　　金：北京医学奖励基金(YXJL-2019-0163-0022)。

摘　　要：目的观察帕瑞昔布钠对幕上脑肿瘤术后脑水肿、炎症反应和相关安全性指标的影响。方法将80例择期行幕上颅脑肿瘤切除术的患者随机分为对照组和实验组,每组40例。实验组分别在麻醉诱导前10min、术后2h静脉注射帕瑞昔布钠40mg,并且在术后第2、3天,以Q12h再给予静脉注射帕瑞昔布钠40mg治疗2d。对照组以相同方式静注生理盐水4mL。分别记录患者手术前后不同时间点脑水肿程度、炎性细胞、凝血功能和生命体征的变化,并记录患者术后疼痛评分、不良反应、入住ICU时间和住院时间。结果实验组与对照组比较,帕瑞昔布钠可以降低术后1d的疼痛评分、住院时间和术后1、3d的平均动脉压和体温。而炎性细胞、凝血功能、不良反应、入住ICU时间在两组患者中无明显差异。结论帕瑞昔布钠可减轻脑肿瘤术后围术期的疼痛,保持生命体征平稳,安全性好,可以缩短住院时间。Objective To observe the effect of parecoxib sodium on cerebral edema,inflammatory response and related safety indexes after supratentorial brain tumor surgery.Methods 80 patients scheduled for supratentorial brain tumor resection were randomly divided into the control group and the experimental group,with 40 cases in each group.The experimental group was injected intravenously 40 mg of parecoxib sodium 10 min before anesthesia induction and 2 hours after operation respectively,and was injected intravenously 40 mg of parecoxib sodium at Q12 h on the 2 nd and 3 rd days after operation for 2 days.The control group received 4 mL of normal saline intravenously in the same way.The changes of cerebral edema,inflammatory cells,coagulation function and vital signs at different time points before and after the operation were recorded respectively,and the postoperative pain scores,adverse reactions(ADRs),ICU admission time and hospitalization time were recorded.Results Compared with the control group,parecoxib sodium in the experimental group can reduce the pain scores and hospitalization time one day after operation,and lower mean arterial pressure and body temperature one day and three days after operation.By contrast,there was no significant difference in inflammatory cells,coagulation function,ADRs and ICU admission time between the two groups.Conclusion Parecoxib sodium can relieve perioperative pain after brain tumor surgery,maintain stable vital signs,and shorten hospitalization time.It also has sound safety.

关 键 词：帕瑞昔布钠 幕上肿瘤 脑水肿 炎症反应 

分 类 号：R971[医药卫生—药品]