酒石酸布托啡诺对重症监护室高血压脑出血患者术后炎症因子及尿α1-微球蛋白的影响  

Effects of Butorphanol Tartrate on Inflammatory Factors and Urinaryα1-Microglobulin in Patients with Hypertensive Cerebral Hemorrhage in Intensive Care Unit After Surgery

作　　者：胡龙 贺蛟龙 时淑娟 李康花 HU Long;HE Jiaolong;SHI Shujuan;LI Kanghua(Dept.of Critical Care Medicine,People’s Hospital of Xiangxi Tujia-Miao Autonomous Prefecture,Hunan Jishou 416000,China;Dept.of Critical Care Medicine,Jishou University Medical College,Hunan Jishou 416000,China)

机构地区：[1]湘西土家族苗族自治州人民医院重症医学科,湖南吉首416000 [2]吉首大学医学院,湖南吉首416000

出　　处：《中国医院用药评价与分析》2023年第4期452-455,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：湖南省医学会医学科研基金—围术期管理及抗抑郁新型药物临床研究科研项目(No.HNA202101030)。

摘　　要：目的:观察重症监护室(ICU)高血压脑出血患者术后使用酒石酸布托啡诺的镇痛效果,并探讨酒石酸布托啡诺对患者炎症因子、尿α1-微球蛋白(α1-MG)的影响。方法:选择2020年8月至2021年7月湘西土家族苗族自治州人民医院ICU收治的140例高血压脑出血患者,采用随机数字表法分为观察组与对照组,各70例。两组患者均在全身麻醉下行小骨窗微创手术,对照组患者术后静脉滴注吗啡镇痛,观察组患者术后静脉滴注酒石酸布托啡诺镇痛。采用广义估计方程分析术后6、12、24和48 h两组患者的镇痛效果[视觉模拟评分法(VAS)],比较术前、术后24 h两组患者炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和超敏C反应蛋白(hs-CRP)]及尿α1-MG水平,统计两组患者不良反应发生情况。结果:术后6、48 h,两组患者VAS评分比较,差异均无统计学意义(P>0.05);术后12、24 h,观察组患者的VAS评分低于对照组,差异均有统计学意义(P<0.05);广义估计方程分析结果显示,两组患者VAS评分组间、时点、组间时点交互比较,差异有统计学意义(P<0.05)。术后24 h,两组患者的IL-6、TNF-α、hs-CRP水平及尿α1-MG水平显著高于术前,但观察组患者低于对照组,差异均有统计学意义(P<0.05);两组患者不良反应总发生率的差异无统计学意义(P>0.05)。结论:酒石酸布托啡诺用于ICU高血压脑出血患者术后镇痛,具有显著的镇痛效果,可有效减轻患者术后炎症反应,减少肾损伤。OBJECTIVE:To observe the analgesic effect of butorphanol tartrate in patients with hypertensive cerebral hemorrhage in intensive care unit(ICU)after surgery,and to probe into the effect of butorphanol tartrate on inflammatory factors and urinaryα1-microglobulin(α1-MG)in patients.METHODS:Totally 140 patients with hypertensive cerebral hemorrhage admitted into ICU of People’s Hospital of Xiangxi Tujia-Miao Autonomous Prefecture from Aug.2020 to Jul.2021 were selected and randomly divided into the observation group and control group using random number table method,with 70 cases in each group.Both groups received minimally invasive surgery with small bone window under general anesthesia,the control group was given intravenous morphine for analgesia after surgery,while patients in the observation group was given intravenous butorphanol tartrate for analgesia after surgery.Generalized estimating equation was used to analyze the analgesic effects[visual analogue scoring(VAS)]of the two groups at 6,12,24 and 48 h after surgery,and to compare the inflammatory factors[interleukin 6(IL-6),tumor necrosis factor alpha(TNF-α)and hypersensitive C-reactive protein(hs-CRP)]and urinaryα1-MG level between two groups before surgery and 24 h after surgery,and the incidences of adverse drug reactions in the two groups were collected.RESULTS:At 6 and 48 h after surgery,the differences in VAS scores between two groups were not statistically significant(P>0.05);at 12 and 24 h after surgery,the VAS scores of the observation group were lower than those of the control group,with statistically significant differences(P<0.05);the results of generalized estimating equation analysis showed that the differences were statistically significant when comparing VAS scores between groups,at time points,and between groups at time points interactively(P<0.05).At 24 h after surgery,the IL-6,TNF-α,hs-CRP and urinaryα1-MG levels in two groups were significantly higher than those before surgery,while the observation group was lower than the control

关 键 词：高血压脑出血 重症监护室 酒石酸布托啡诺 炎症因子 尿Α1-微球蛋白 

分 类 号：R971[医药卫生—药品]