多模式超前镇痛对腹式全子宫切除术患者炎性因子、疼痛介质、应激激素及免疫功能影响  

Effects of multimodal preemptive analgesia on the levels of inflammatory factors,pain mediators,stress hormone and immune function in patients with abdominal hysterectomy

作　　者：金英杰 JIN Yingjie(Jiangsu Shengze Hospital,Wujiang,Jiangsu Province,215228)

机构地区：[1]江苏盛泽医院,吴江215228

出　　处：《中国计划生育学杂志》2021年第1期97-101,共5页Chinese Journal of Family Planning

摘　　要：目的:观察多模式超前镇痛对腹式全子宫切除术患者术后炎性因子、疼痛介质、应激激素水平及免疫功能的影响。方法:2014年1月-2018年12月本院收治的行腹式全子宫切除术手术患者110例,根据镇痛方式不同分为对照组和观察组各55例。对照组给予术后镇痛,观察组给予多模式超前镇痛。比较两组患者术后6h、12h、24h、48 h视觉模拟评分(VAS),血清炎性因子水平,肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)及白介素-10(IL-10),疼痛介质P物质(SP)、前列腺素E2(PGE2)、β-内啡肽(β-EP)水平,血清应激激素去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、皮质醇(Cor)水平以及免疫功能IgG、IgM、IgA水平。结果:术后6h、12h、24h,观察组VAS评分、TNF-α、IL-6、IL-10、SP、PGE2均低于对照组,β-EP、IgG、IgM及IgA均高于对照组(均P<0.05);术后48 h观察组血清TNF-α、IL-6、IL-10、SP、PGE2均低于对照组,β-EP、IgG、IgM、IgA均高于对照组(P<0.05),而VAS评分两组无差异(P>0.05)。结论:多模式超前镇痛可有效抑制腹式全子宫切除术患者术后炎性因子分泌,降低机体炎性反应;减少机体疼痛介质分泌而降低疼痛感受,抑制应激激素分泌而减少机体应激反应,同时提高了患者免疫功能。Objective:To study the effect of multimodal preemptive analgesia on the levels of inflammatory factors,pain mediators,and stress hormone,and immune function of patients with abdominal hysterectomy.Methods:110 patients who underwent abdominal hysterectomy were selected and divided into control group and observation group(55 cases in each group)according to different analgesic methods from January 2015 to December 2018.The patients in the control group were given postoperative analgesia,while the patients in the observation group were given multimodal preemptive analgesia.The visual analogue scale(VAS)score,the levels of serum inflammatory factors,such as TNF-α,IL-6 and IL-10,the levels of serum pain mediators,such as substance P(SP),prostaglandin E2(PGE2),β-endorphin(β-EP),the levels of serum stress hormone,such as adrenaline(NE),angiotensin II(Ang II),cortisol(Cor),and the levels of immune function index,such as IgG,IgM and IgA of the patients at 6h,12h,24h and 48h after operation were compared between the two groups.Results:At 6h,12h,24h and 48h after operation,the VAS score,and the levels of TNF-α,IL-6,IL-10,SP and PGE2 of the patients in the observation group were significant lower than those of the patients in the control group,but the levels ofβ-EP,IgG,IgM and IgA of the patients in the observation group were significant higher(P<0.05).At 48h after operation,the levels of TNF-α,IL-6,IL-10,SP and PGE2 of the patients in the observation group were significant lower than those in the control group,but the levels ofβ-EP,IgG,IgM and IgA of the patients in the observation group were significant higher(P<0.05),while there was no significant difference in VAS score of the patients between the two groups(P>0.05).Conclusion:Multimodal preemptive analgesia can inhibit the secretion of inflammatory factors of patients with abdominal hysterectomy and reduce their inflammatory response effectively.The pain symptom of patients is relieved by reducing the secretion of pain mediators,and the stress response of patient

关 键 词：腹式全子宫切除术 多模式超前镇痛 炎性因子 应激激素 免疫功能 疼痛介质 

分 类 号：R614[医药卫生—麻醉学]