小剂量舒芬太尼在乳腺肿物切除术患者术后镇痛中的应用价值  

Analysis of the Application Value of Low-dose Sufentanil in Postoperative Analgesia of Patients Undergoing Breast Lumpectomy

作　　者：居斌华 殷霞丽[1] 孙玉娥 周瑜[1] 蒋忠[1] JU Bin-hua;YIN Xia-li;SUN Yu-e;ZHOU Yu;JIANG Zhong(Department of Anesthesiology,Nanjing Gulou Hospital,Nanjing University School of Medicine,Nanjing,Jiangsu,210000,China)

机构地区：[1]南京大学医学院附属南京鼓楼医院麻醉科,江苏南京210000

出　　处：《现代生物医学进展》2021年第21期4079-4082,4112,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(81870871)。

摘　　要：目的:探讨与分析小剂量舒芬太尼在乳腺肿物切除术患者术后镇痛中的应用价值。方法:2019年6月到2020年6月选择在南京大学医学院附属南京鼓楼医院进行乳腺肿物切除术的患者84例作为研究对象,根据随机信封抽签原则把患者分为研究组与对照组各42例。所有患者均采用气管插管全身麻醉,研究组与对照组术后分别采用剂量为0.010 mg/kg与0.020 mg/kg舒芬太尼进行自控静脉镇痛。记录两组患者围术期相关指标以及并发症发生情况;在术后12 h、24 h与36 h评定患者的疼痛状况;术前1 d与术后7 d应用放射免疫分析法检测血清肿瘤坏死因子(Tumor necrosis factor,TNF)-α、白介素(Interleukin,IL)-6等炎症因子含量。结果:所有患者均顺利完成手术与麻醉。研究组术后7 d的呼吸抑制、寒颤、躁动、恶心呕吐、肌肉僵硬等并发症发生率为4.8%,显著低于对照组的28.6%(P<0.05)。两组术后7 d的血清TNF-α、IL-6水平低于术前1 d,研究组均显著低于对照组(P<0.05)。其余指标两组差异均无统计学意义(P>0.05)。结论:小剂量舒芬太尼在乳腺肿物切除术患者术后镇痛中的应用能抑制炎症因子的释放,且不会影响手术、麻醉与镇痛效果,能减少患者术后并发症的发生。Objective:To explore and analysis the application value of low-dose sufentanil in postoperative analgesia for patients undergoing breast tumor resection.Methods:From June 2019 to June 2020,84 cases of patients who underwent breast tumor resection in Nanjing Gulou Hospital,Nanjing University School of Medicine were selected as the research objects.All the cases were divided into the study group and control group with 42 cases each groups accorded to the principle of random envelope drawing.All patients underwent general anesthesia with tracheal intubation.The study group and the control group were treated with 0.010 mg/kg and 0.020 mg/kg sufentanil for self-controlled intravenous analgesia after operation.Perioperative indicators and complications of the two groups of patients were recorded;The pain status of patients at 12 h,24 h and 36 h after operation was assessed;Radioimmunoassay was used to detect serum TNF-α,IL-6 and other inflammatory factors 1 d before operation and 7 d after operation.Results:All patients successfully completed the operation and anesthesia.The incidence of complications such as respiratory depression,chills,restlessness,nausea and vomiting,and muscle stiffness in the study group 7 days after operation was 4.8%,which was significantly lower than the 28.6%in the control group(P<0.05).The levels of serum tumor necrosis factor(TNF)-αand interleukin(IL)-6 on the 7 th day after operation in the two groups were lower than those on the 1 day before operation(P<0.05).The study group was significantly lower than the control group(P<0.05).There was no statistically significant difference in the other indexes between the two groups(P>0.05).Conclusion:The application of low-dose sufentanil in postoperative analgesia for patients with breast tumor resection can inhibit the release of inflammatory factors without affect the effects of surgery,anesthesia and analgesia,and it can reduce the incidence of postoperative complications in patients.

关 键 词：剂量 舒芬太尼 乳腺肿物切除术 镇痛 炎症因子 并发症 

分 类 号：R655.8[医药卫生—外科学] R737.9[医药卫生—临床医学]