两种药物的术后镇痛效果比较及对血清SOD、CAT、外周血免疫细胞水平的影响  

Comparison of postoperative analgesic effect between two drugs and their effects on serum SOD,CAT and peripheral blood immune cells levels

作　　者：何玲[1] 李秀泽[1] 李军[1] 张永洪[1] 黄雪梅[1] 杜娟[1] HE Ling;LI Xiuze;LI Jun;ZHANG Yonghong;HUANG Xuemei;DU Juan(Department of Anesthesiology,Mianyang Municipal Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川省绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《国际检验医学杂志》2021年第2期151-154,160,共5页International Journal of Laboratory Medicine

基　　金：四川省卫生和计划生育委员会科研课题(17PJ232);四川省绵阳市中心医院院级课题(2019YJ17)。

摘　　要：目的比较纳布啡、舒芬太尼的术后镇痛效果,以及对血清超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、外周血免疫细胞水平的影响。方法选取2017年5月至2019年12月于该院手术室进行全身麻醉手术的140例患者,随机分为观察组及对照组,每组70例。术后两组患者均采用静脉自控镇痛方式进行镇痛,观察组给予纳布啡,对照组给予舒芬太尼,通过镇静评分(Ramsay评分)量表及Wong-Baker面部表情量表评分比较两组患者的镇静、镇痛效果,采集患者手术前后外周血分析两组患者的免疫功能,以及检测血清SOD、CAT水平。结果两组患者术后1、3 h的Ramsay评分比较,差异无统计学意义(P>0.05),观察组患者术后6、9、12、24、36 h的Ramsay评分明显高于对照组(P<0.05)。术后1、3 h,患者的Wong-Baker面部表情量表评分差异无统计学意义(P>0.05),术后6、9、12、24、36 h,观察组患者的Wong-Baker面部表情量表评分明显低于对照组(P<0.05)。术后观察组患者的CD3+、CD4+、CD8+、CD14+、CD25+T细胞比例明显高于对照组(P<0.05)。与对照组相比,术后观察组患者的SOD、CAT水平明显下降(P<0.05)。结论相较于舒芬太尼,患者全身麻醉术后应用纳布啡,可降低SOD、CAT水平,改善免疫功能,镇痛效果显著,建议临床推广、应用。Objective To compare the postoperative analgesic effects of nalbuphine and sufentanil and their effects on the levels of serum superoxide dismutase(SOD),catalase(CAT)and peripheral blood immune cells levels.Methods One hundred and forty patients undergoing general anesthesia operation in the operating room of this hospital from May 2017 to December 2019 were selected and randomly divided into the observation group and control group,70 cases in each group.After the operation,the patients in both groups adopted the intravenous self controlled analgesia for conducting analgesia.The observation group was given nalbuphine,and the control group was given sufentanil.The analgesic and sedative effects were compared between the two groups by adopting the Ramsay scale and Wong-Baker facial expression scale.The immune function was analyzed by collecting peripheral blood and the serum SOD,CAT levels before and after operation were detected.Results The Ramsay scores at postoperative 1,3 h had no statistically significant difference between the two groups(P>0.05).The Ramsay scores at postoperative 6,9,12,24,36 h in the observation group were significantly higher than those in the control group(P<0.05);the Wong Baker facial expression scale scores at postoperative 1,3 h had no statistical difference between the two groups(P>0.05);the Wong Baker facial expression scale scores at postoperative 6,9,12,24,36 h in the observation were significantly lower than those in the control group(P<0.05).The postoperative CD3+,CD4+,CD8+,CD14+,CD25+T cell proportion in the observation group were significantly higher than those in the control group(P<0.05).Compared with the control group,the postoperative SOD and CAT levels in the observation group were significantly decreased(P<0.05).Conclusion Compared with sufentanil,the application of nalbuphine after general anesthesia can reduce the levels of SOD and CAT,improves the immune function and has the significant analgesic effect,which is recommended to promote and apply in clinic.

关 键 词：纳布啡 舒芬太尼 镇痛 镇静 

分 类 号：R446.63[医药卫生—诊断学]