超前镇痛在子宫动脉介入栓塞术后的疗效和对炎症、免疫功能的影响  

Curative Effect of Preemptive Analgesia after Uterine Artery Interventional Embolization and the Influences on Inflammation and Immune Function

作　　者：王静[1] 黄金凤[1] 李岳勇[1] 李北林[1] 杨梅[1] WANG Jing;HUANG Jinfeng;LI Yueyong;LI Beilin;YANG Mei(Youjiang Medical College for Nationalities Affiliated Hospital,Baise 533000,China;不详)

机构地区：[1]右江民族医学院附属医院,广西百色533000

出　　处：《中外医学研究》2023年第13期1-6,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：百色市科学研究与技术开发计划项目(20160630)。

摘　　要：目的:探究超前镇痛在子宫动脉介入栓塞术后的疗效和对炎症、免疫功能的影响。方法:选取2016年10月—2019年3月右江民族医学院附属医院妇产科及肿瘤介入科收治的55例子宫动脉介入栓塞的患者为研究对象,根据患者意愿分为对照组17例(术前患者不愿意使用止痛药物)、PICC组19例[阿片类药物芬太尼为主的多模式经外周静脉穿刺中心静脉置管(PICC)静脉可控式止痛泵镇痛]、曲马多组19例(曲马多治疗)。比较三组患者术前与术后24 h、48 h视觉模拟疼痛评分(VAS)、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、细胞免疫功能变化(CD8^(+)、CD4^(+)和CD4^(+)/CD8^(+))和布氏舒适度评分(BCS)及术前与出院时健康调查简表(SF-36)评分。比较三组术后镇痛药物使用情况、疼痛缓解度与不良反应发生情况。结果:三组术前VAS评分、BCS评分比较,差异无统计学意义(P>0.05)。术后24 h、48 h,PICC组VAS评分低于对照组与曲马多组,且BCS评分高于对照组与曲马多组,差异有统计学意义(P<0.05)。三组术前TNF-α和IL-6水平比较,差异无统计学意义(P>0.05);术后24 h、48 h,PICC组TNF-α和IL-6水平低于对照组与曲马多组,差异有统计学意义(P<0.05)。术前,三组细胞免疫功能比较,差异无统计学意义(P>0.05);术后24 h、48 h,PICC组CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组与曲马多组,CD8^(+)水平低于对照组与曲马多组,差异有统计学意义(P<0.05)。PICC组药物用量少于对照组与曲马多组,差异有统计学意义(P<0.05)。三组术前SF-36评分比较,差异无统计学意义(P>0.05);出院时PICC组生理功能、身体疼痛、精神健康、角色限制、社会功能、活力、情感职能和总体健康评分显著高于对照组与曲马多组,差异有统计学意义(P<0.05)。PICC组术后疼痛缓解度(73.68%)略高于曲马多组(68.42%),但两组比较差异无统计学意义(P>0.05)。曲马多组与PICC组疼�Objective:To explore the curative effect of preemptive analgesia after uterine artery interventional embolization and the influences on inflammation and immune function.Method:A total of 55 patients with uterine artery interventional embolization admitted to the Department of Obstetrics and Gynecology and Tumor Intervention in Youjiang Medical College for Nationalities Affiliated Hospital from October 2016 to March 2019 were selected as the study subjects,according to the wishes of the patients,they were divided into control group(17 patients were unwilling to use painkillers before operation),PICC group(19 patients were in the multimode PICC intravenous controlled painkillers with Fentanyl as the opioid),and Tramadol group(19 patients used Tramadol treatment).The visual analogous scale(VAS),serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],changes in cellular immune function(CD8^(+),CD^(+)and CD^(+)/CD8^(+)),Bruggrmann comfort scale(BCS)of the two groups of patients before and 24 h and 48 h after operation and the MOS item short from health survey(SF-36)before and after discharge were observed.The use of analgesics,pain relief and adverse reactions were observed in the three groups.Result:There were no statistically significant differences in VAS and BCS scores among three groups before operation(P>0.05).The VAS scores of PICC group were significantly lower than those of control group and Tramadol group at 24 h and 48 h after operation,and the BCS scores were significantly higher than those of control group and Tramadol group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the level of TNF-αamong the three groups before operation(P>0.05).The levels of TNF-αand IL-6 in PICC group at 24 h and 48 h after operation were significantly lower than those of control group and Tramadol group,the differences were statistically significant(P<0.05).There were no statistically significant differences in cellular immune function amon

关 键 词：超前镇痛 子宫动脉介入栓塞术 炎症 免疫功能 临床疗效 

分 类 号：R713.4[医药卫生—妇产科学]