腹腔镜子宫全切术术前纳布啡用药对患者术后疼痛及炎症因子表达的影响  

Influence of preoperative administration of naborphine on the pain degree and the inflammatory factor expression level of the patients after laparoscopic hysterectomy

作　　者：王举[1] 段佳佳[1] 吕志排[1] 王涛[1] 姜丽华[1] WANG Ju;DUAN Jiajia;LV Zhipai;WANG Tao;JIANG Lihua(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province,450052)

机构地区：[1]郑州大学第三附属医院,450052

出　　处：《中国计划生育学杂志》2022年第2期315-318,共4页Chinese Journal of Family Planning

摘　　要：目的:探究腹腔镜子宫全切术前纳布啡用药对患者术后疼痛及高迁移率族蛋白B1(HMGB1)表达的影响。方法:选取2019年1月-2020年1月本院行腹腔镜子宫全切术患者80例,按数字表法随机分为观察组和对照组各40例,于麻醉诱导前10 min观察组静脉推注盐酸纳布啡注射液0.2 mg/kg,对照组推注等量生理盐水。观察两组不同麻醉时刻生命体征指标、血清HMGB1表达和白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)水平及疼痛程度的变化,评估不良反应。结果:麻醉诱导前30 min(T1)时,两组平均动脉压(MAP)、心率(HR)及血清HMGB1表达、IL-6、TNF-α水平均无差异(P>0.05);与T1时相比,两组术后2 h(T2)、6 h(T3)、12 h(T4)时MAP、HR及血清HMGB1表达、IL-6、TNF-α水平均升高但观察组低于对照组(P<0.05)。观察组T2(4.00±0.78分)、T3(3.27±0.52分)、T4(2.11±0.43分)时疼痛视觉模拟(VAS)评分均低于对照组(4.57±0.85分、3.75±0.64分、2.11±0.43分),术后总不良反应发生率(7.5%)低于对照组(35.0%)(均P<0.05)。结论:腹腔镜子宫全切术纳布啡术前用药可有效改善患者术后疼痛,降低机体炎症反应和术后不良反应。Objective: To investigate the influence of preoperative administration of naborphine on the pain degree and the high mobility group protein B1(HMGB1) expression level of the patients after laparoscopic hysterectomy. Methods: From January 2019 to January 2020, 80 patients who underwent laparoscopic hysterectomy were selected as the study objects, and were randomly divided into study group and control group(40 cases in each group) according to the digital table method. The patients in the study group were injected 0.2 mg/kg of nabufine hydrochloride intravenously at 10 minutes before anesthesia induction, and the patients in the control group were given the same amount of normal saline intravenously at 10 minutes before anesthesia induction. The changes of the vital signs indexes values, the levels of serum HMGB1, interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α), and the pain degree of the patients in the two groups at different time of anesthesia were observed. The adverse reactions of the patients in the two groups were evaluated. Results: There were no significant differences in the values of mean arterial pressure(MAP) and heart rate(HR), and the levels of serum HMGB1 expression, IL-6, and TNF-α of the patients at 30 min before anesthesia induction(T1) between the two groups(P>0.05). The values of MAP and HR, and the levels of serum HMGB1 expression, IL-6, and TNF-α of the patients in the two groups at 2 h after operation(T2), 6 h after operation(T3), and 12 h after operation(T4) were significantly higher than those at T1, and which of the patients in the study group were significantly lower than those of the patients in the control group(P<0.05). The visual analogue scale(VAS) scores of the patients at T2(4.00±0.78 points), T3(3.27±0.52 points), and T4(2.11±0.43 points) in the study group were significantly lower than those(4.57±0.85 points,3.75±0.64 points,and 2.11±0.43 points)of the patients in the control group.The incidence of total postoperative adverse reactions(7.5%)of the patients in t

关 键 词：腹腔镜子宫全切术 纳布啡 术前用药 术后镇痛 炎症因子 不良反应 

分 类 号：R713.4[医药卫生—妇产科学]