选择性环氧化酶-2抑制剂用于腹腔镜胆囊切除术Ⅰ类切口手术的止痛效果研究  

Analgesic Effect of Selective Cyclooxygenase-2 Inhibitor on TypeⅠIncision in Laparoscopic Cholecystectomy

作　　者：陈宏[1] 刘磊 CHEN Hong;LIU Lei(Hanzhong Central Hospital,Hanzhong 723000,Shaanxi)

机构地区：[1]陕西省汉中市中心医院,陕西汉中723000

出　　处：《医学临床研究》2021年第5期734-736,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镋胆囊切除术Ⅰ类切口手术患者围术期应用选择性环氧化酶-2抑制剂的价值。【方法】选取本院84例胆囊结石行腹腔铣胆囊切除术Ⅰ类切口手术患者,根据围术期止痛方法的不同将其分为观察组和对照组,各42例。观察组围术期使用选择性环氧化酶-2抑制剂(塞来昔布、帕瑞昔布钠),对照组采取常规镁痛,比较两组术后疼痛情况、环氧合酶-2(COX-2)、前列腺素E2(PGE2)表达水平及不良反应发生率。【结果】术后12 h、24 h、48 h,两组患者VAS评分显著高于术前,且观察组低于对照组,差异均有统计学意义(P<0.05)。术后即刻、术后48 h,两组患者血清PGE2、COX-2显著低于术前,观察组PGE2水平显著低于对照组.COX-2低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为9.52%(4/42),低于对照组的14.29%(6/42),但差异无统计学意义(χ^(2)=0.454,P=0.500>0.05)。【结论】腹腔镜胆囊切除术Ⅰ类切口手术患者围术期应用选择性环氧化酶-2抑制剂具有良好的镇痛效果,且安全性较高。[Objective]To study the value of selective cyclooxygenase-2 inhibitors in perioperative patients undergoing laparoscopic cholecystectomy with typeⅠincision.[Methods]A total of 84 patients with gallstone underwent laparoscopic cholecystectomy typeⅠincision were selected.According to the different methods of perioperative pain relief,they were divided into observation group and control group,42 cases respectively.The patients in the observation group were treated with selective cyclooxygenase-2 inhibitors(celecoxib and perrickib sodium)during the perioperative period.The control group took routine analgesia,compared the postoperative pain,the expression of COX-2,PGE2 and the incidence of adverse reactions.【Results】At 12 h,24 h and 48 h after operation,the VAS score of the two groups was significantly higher than that before operation,and the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).Immediately after operation and 48 hours after operation,the levels of PGE2 and COX-2 in the two groups were significantly lower than those before operation.The levels of PGE2 and COX-2 in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 9.52%(4/42),which was lower than 14.29%(6/42)in the control group»but the difference was not statistically significant(χ^(2)=0.454,P=0.500〉0.05).【Conclusion】Selective cyclooxygenase-2 inhibitor has good analgesic effect and high safety in patients with typeⅠlaparoscopic cholecystectomy incision.

关 键 词：胆结石/外科学 胆囊切除术 腹腔镜 环加氧酶抑制药 外科伤口 镇痛药 

分 类 号：R605[医药卫生—外科学]