| 李晓玲,孙亚玲,潘志高,钱 斌,嵇富海.盐酸羟考酮对肠道肿瘤术后患者镇痛效果及免疫功能的影响[J].,2017,17(25):4916-4919 |
| 盐酸羟考酮对肠道肿瘤术后患者镇痛效果及免疫功能的影响 |
| Influence of Oxycodone Hydrochloride on Patients with Intestinal Tumor on Analgesic Effect and Immune Function after Operation |
| 投稿时间：2016-12-27 修订日期：2017-01-25 |
| DOI：10.13241/j.cnki.pmb.2017.25.028 |
| 中文关键词: 羟考酮 术后 镇痛 肿瘤 免疫功能 |
| 英文关键词: Oxycodone Postoperative Analgesia Tumor Immune function |
| 基金项目: |
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| 中文摘要: |
| 摘要 目的：探讨盐酸羟考酮对肠道肿瘤术后患者的镇痛效果及免疫功能的影响。方法：选择2014年6月至2016年12月我院收治并行手术治疗的肠道肿瘤患者50例，按照随机数字表法分为羟考酮组及芬太尼组，每组各25例。羟考酮组患者于手术结束前15 min给予盐酸羟考酮5 mg静脉注射；芬太尼组患者于手术结束前15 min给予芬太尼50 ug静脉注射。两组术后分别启动盐酸羟考酮与芬太尼静脉自控镇痛。观察两组术后3 h（T0）、6 h（T1）、12 h（T2）、24 h（T3）、48h（T4）视觉模拟评分（VAS）、Ramsey镇静评分变化；检测麻醉前、T2、T3、T4血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平以及CD4+、CD8+、CD4+/CD8+、NK细胞水平，并对比两组术后不良反应发生情况。结果：T1、T2时点羟考酮组Ramsey评分显著低于芬太尼组（P<0.05），T0、T3、T4时点两组Ramsey评分比较无统计学差异（P>0.05）。T2、T3、T4时点两组患者血清TNFα、IL-6和IL-10较麻醉前均显著升高（P<0.05），羟考酮组TNF-α、IL-6和IL-10显著低于芬太尼组（P<0.05）。T2、T3、T4时点两组患者CD4+、CD4+/CD8+显著降低，CD8+显著升高（P<0.05），羟考酮组CD4+、CD4+/ CD8+显著高于芬太尼组，CD8+显著低于芬太尼组（P<0.05），T2、T3时点两组患者NK细胞显著降低，羟考酮组NK细胞显著高于芬太尼组（P<0.05）。两组患者术后恶心、呕吐、呼吸抑制、头晕、皮肤瘙痒发生率比较差异无统计学意义（P>0.05）。结论：盐酸羟考酮对肠道肿瘤患者免疫功能影响较小，适合肠道肿瘤患者。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of oxycodone hydrochloride on patients with analgesic effect and immune function of intestinal tumor after operation. Methods: 50 patients with intestinal tumor from June 2014 to December 2016 who were treated in our hospital were selected randomly to divide into oxycodone group and fentanyl group with 25 cases in each group. Patients in oxycodone group were given oxycodone hydrochloride intravenous injection of 5mg 15 minutes before the end of surgery; and patients in fentany group were given fentany intravenous injection of 50ug 15 minutes before the end of surgery. Visual analogue scale (VAS), ramsey seda- tion score were observed at 3 h (T0), 6 h (T1), 12 h (T2), 24 h (T3) 48 h (T4) after operation, Levels of serum tumor necrosis factor -α (TNF-α), interleukin -6 (IL-6) and IL-10 CD4+, CD8+, CD4+/CD8+ and NK cells measured before anesthesia, and at T2, T3, T4 respectively. Results: At time point of T1, T2, Ramsey scores of oxycodone group were significantly lower than that of fentany group (P<0.05), At time point of T0, T3, T4, Ramsey scores of the two groups showed no significant difference (P>0.05). At time point of T2, T3, T4, levels of serum TNF-α, IL-6 and IL-10 of two groups of patients were significantly higher than those of anesthesia before (P<0.05), TNF-α, IL-6 and IL-10 of oxycodone group was significantly lower than those of fentany group (P<0.05). At time point of T2, T3, T4, CD4+/ at CD4+ of the two groups were significantly decreased, and CD8+ was significantly increased(P<0.05). Levels of CD4+, CD4+/ CD8+ of oxycodone group was significantly higher than that of fentany group (P<0.05), and level of CD8+ was significantly higher than that of fentany group.At time point of T2, T3, NK cells of two groups were significantly decreased, NK cells of oxycodone group were significantly higher than that of oxycodone group (P<0.05). Differences among postoperative nausea, vomiting, respiratory depression,dizziness, skin itching incidence of two groups of patients were not statistically significant(P>0.05). Conclusion: Oxycodone hydrochloride has little effect on the immune function of patients with intestinal tumor, and it is suitable for Postoperative analgesia of patients with intestinal tumor. |
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