盐酸氢吗啡酮对胆囊结石患者气管插管应激反应及细胞因子的影响  

Effect of Hydromorphone Hydrochloride on Stress Response and Cytokine in Patients with Cholecystolithiasis after Endotracheal Intubation

作　　者：冯海珍[1] 杨建超 FENG Haizhen;YANG Jianchao(Department of Anesthesia,Mianchi County People’s Hospital,Sanmenxia Henan 472499,China;Department of Anesthesia,Xinye County People’s Hospital,Nanyang Henan 473500,China)

机构地区：[1]渑池县人民医院麻醉科,河南三门峡472499 [2]新野县人民医院麻醉科,河南南阳473500

出　　处：《临床研究》2023年第12期67-70,共4页Clinical Research

摘　　要：目的探究盐酸氢吗啡酮对行胆囊切除术的胆囊结石患者气管插管应激反应及细胞因子的影响。方法纳入2018年2月至2020年2月期间于渑池县人民医院行胆囊切除术的胆囊结石患者100例进行前瞻性研究,按照随机数字表法分为两组,各50例。两组均静脉给药麻醉前诱导,静脉注射完毕后给予对照组生理盐水,给予观察组盐酸氢吗啡酮。对比两组诱导前、插管即刻、插管后5 min应激反应[血浆肾上腺素(E)、多巴胺(DA)]、细胞因子[白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)]变化、血流动力学指标[心率(HR)、平均动脉压(MAR)]、康复进程、生活质量和不良反应。结果诱导前,两组血浆E水平、血浆DA水平比较,差异无统计学意义(P>0.05);两组插管即刻、插管后5 min时的血浆E水平、血浆DA水平均高于诱导前,但观察组低于对照组,差异有统计学意义(P<0.05)。诱导前,两组IL-1水平、TNF-α水平、IL-8水平比较,差异无统计学意义(P>0.05);两组插管即刻、插管后5min时的IL-1水平、TNF-α水平、IL-8水平均高于诱导前,但观察组低于对照组,差异有统计学意义(P<0.05)。诱导前,两组HR、MAP水平比较,差异无统计学意义(P>0.05);两组插管即刻、插管后5min时的HR、MAP水平均高于诱导前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后康复进程的各项指标均优于对照组,差异有统计学意义(P<0.05)。术前,两组生活质量评分比较,差异无统计学意义(P>0.05);术后,两组生活质量评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率(4.00%)低于对照组(18.00%),差异有统计学意义(P<0.05)。结论行胆囊切除术的胆囊结石患者应用盐酸氢吗啡酮,利于降低气管插管应激反应和炎症因子,使机体的血流动力学得到有效改善,不仅让患者的康复进度和生活质量均得到有效提高,而�Objective To investigate the effects of hydromorphone hydrochloride on tracheal intubation stress response and cytokines in patients with gallstones undergoing cholecystectomy.Methods A prospective study was conducted on 100 patients with gallbladder stones who underwent cholecystectomy at the Xinye County People’s Hospital from February 2018 to February 2020.They were divided into two groups using a random number table method,with 50 patients in each group.Both groups were induced before intravenous anesthesia,and after intravenous injection,the control group was given physiological saline,while the observation group was given hydromorphone hydrochloride.Compare the stress responses of two groups before induction,immediately after intubation,and 5 minutes after intubation[plasma adrenaline(E),dopamine(DA)],cytokines[interleukin-1(IL-1),and tumor necrosis factor]-α(TNF-α),Changes in interleukin-8(IL-8),hemodynamic indicators[heart rate(HR),mean arterial pressure(MAR)],rehabilitation progress,quality of life,and adverse reactions.Results Immediately after intubation and 5 minutes after intubation,the levels of plasma E and DA in both groups increased first and then decreased compared to before induction,and the observation group was lower than the control group at all time points.The differences in interaction between groups,time points,and time points were significant(P<0.05);Immediately after intubation and 5 minutes after intubation,two groups of IL-1 and TNF-α,The average level of IL-8 water was higher than before induction,and the observation group was lower than the control group at all time points.There were significant differences in the interaction between groups,time points,and time points(P<0.05);The levels of HR and MAP immediately after intubation and 5 minutes after intubation in both groups were higher than before induction(P<0.05);The levels of HR and MAP in the observation group immediately after intubation and 5 minutes after intubation were lower than those in the control group(P<0.05);The

关 键 词：胆囊结石 气管插管 盐酸氢吗啡酮 应激反应 细胞因子 

分 类 号：R364.25[医药卫生—病理学]