| 刘 欢,邵 琛,马 垚,胡 玲,张秋实,张 晶.艾司氯胺酮联合舒芬太尼术后镇痛对老年腹腔镜结肠癌根治术患者细胞免疫功能、疼痛因子和认知功能的影响[J].,2024,(2):294-298 |
| 艾司氯胺酮联合舒芬太尼术后镇痛对老年腹腔镜结肠癌根治术患者细胞免疫功能、疼痛因子和认知功能的影响 |
| Effects of Analgesia after Surgery with Esketamine Combined with Sulfentanyl on Cellular Immunity Function, Pain Factors and Cognitive Function in Elderly Patients with Laparoscope Colon Cancer Radical Surgery |
| 投稿时间：2023-07-04 修订日期：2023-07-26 |
| DOI：10.13241/j.cnki.pmb.2024.02.017 |
| 中文关键词: 艾司氯胺酮 舒芬太尼 镇痛 老年 腹腔镜结肠癌根治术 细胞免疫 疼痛因子 认知功能 |
| 英文关键词: Esketamine Sulfentanyl Analgesia Elderly Laparoscope colon cancer radical surgery Cellular immunity Pain factors Cognitive function |
| 基金项目:湖北省自然科学基金一般面上项目（2019CFB417） |
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| 中文摘要: |
| 摘要 目的：观察艾司氯胺酮联合舒芬太尼术后镇痛对老年腹腔镜结肠癌根治术患者疼痛因子、细胞免疫功能、认知功能的影响。方法：纳入武汉科技大学附属天佑医院2021年1月~2022年10月期间收治的老年腹腔镜结肠癌根治术患者156例。根据随机数字表法将患者分为对照组（枸橼酸舒芬太尼注射液术后镇痛）和研究组（盐酸艾司氯胺酮注射液联合枸橼酸舒芬太尼注射液术后镇痛），各78例。对比两组静脉自控镇痛泵（PCIA）有效按压次数、Ramsay镇静评分、疼痛视觉模拟评分（VAS）、细胞免疫功能、疼痛因子、认知功能和不良反应发生率。结果：研究组的PCIA有效按压次数少于对照组（P<0.05）；术后24 h、术后48 h，研究组VAS评分低于对照组，Ramsay镇静评分高于对照组（P<0.05）。术后48 h，研究组β-内啡肽（β-EP）高于对照组，P物质（SP）、前列腺素E2（PEG2）低于对照组（P<0.05）。术后48 h，研究组CD8+低于对照组，CD3+、CD4+、CD4+/CD8+高于对照组（P<0.05）。研究组术后12 h、术后24 h、术后48 h MMSE评分高于对照组（P<0.05）。两组不良反应发生率组间对比未见统计学差异（P>0.05）。结论：艾司氯胺酮联合舒芬太尼术后镇痛用于老年腹腔镜结肠癌根治术患者，可获得较好的镇静、镇痛效果，可减少PCIA有效按压次数，减轻免疫抑制，降低疼痛因子过度分泌，改善认知功能。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of analgesia after surgery with esketamine combined with sulfentanyl on cellular immunity function, pain factors and cognitive function in elderly patients with laparoscope colon cancer radical surgery. Methods: 156 elderly patients with laparoscope colon cancer radical surgery who were admitted to Tianyou Hospital Affiliated to Wuhan University of Science and Technology from January 2021 to October 2022 were included. The patients were divided into control group (analgesia after surgery with sulfentanyl citrate injection) and study group (analgesia after surgery with esketamine hydrochloride injection combined with sulfentanyl citrate injection for analgesia after surgery), 78 cases in each group. The effective number of compressions for intravenous patient-controlled analgesia pump (PCIA), Ramsay sedation score, pain visual analogue score (VAS), cellular immunity function, pain factors, cognitive function and the incidence of adverse reactions were compared between two groups. Results: The number of effective PCIA compressions in study group was less than that in control group (P<0.05). 24 h after surgery and 48 h after surgery, the VAS score in study group was lower than that in control group, Ramsay sedation score was higher than control group (P<0.05). 48 h after surgery, The β-endorphin (β-EP) in study group was higher than that in control group, substance P (SP) and prostaglandin E2 (PEG2) were lower than those in control group (P<0.05). 48h after surgery, CD8+ in study group was lower than that in control group, CD3+, CD4+ and CD4+/CD8+ were higher than those in control group (P<0.05). The MMSE scores in study group at 12 h after surgery, 24 h after surgery and 48 h after surgery were higher than those in control group (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (P>0.05). Conclusion: Analgesia after surgery with esketamine combined with sulfentanyl in elderly patients with laparoscope colon cancer radical surgery can obtain good sedative and analgesic effects, can reduce the number of effective PCIA compressions, relieve the immunosuppression, reduce the excessive secretion of pain factors, and improve cognitive function. |
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