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中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (01) : 46 -49. doi: 10.3877/cma.j/jssn.2096-1537.2017.01.010

所属专题: 镇痛镇静 文献

临床研究

术后镇痛对外伤性脾切除患者免疫细胞因子的影响
涂涛1,(), 王劲1   
  1. 1. 610500 成都医学院第一附属医院麻醉科
  • 收稿日期:2016-08-10 出版日期:2017-02-28
  • 通信作者: 涂涛
  • 基金资助:
    四川省应用基础研究计划项目(2014JY0123)

Effects of post-splenectomy analgesia on cytokines in trumatic splenic rupture patients

Tao Tu1,(), Jin Wang1   

  1. 1. Department of anesthesiology, the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
  • Received:2016-08-10 Published:2017-02-28
  • Corresponding author: Tao Tu
  • About author:
    Tu Tao,Email:
引用本文:

涂涛, 王劲. 术后镇痛对外伤性脾切除患者免疫细胞因子的影响[J]. 中华重症医学电子杂志, 2017, 03(01): 46-49.

Tao Tu, Jin Wang. Effects of post-splenectomy analgesia on cytokines in trumatic splenic rupture patients[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(01): 46-49.

目的

观察术后镇痛对外伤性脾切除手术患者免疫细胞因子的影响。

方法

选取2015年1月至12月本院外伤性脾破裂行脾切除术患者44例,随机分为2组,镇痛组(25例)予以舒芬太尼术后镇痛,对照组(19例)术后泵注等量0.9%氯化钠溶液。采用视觉模拟疼痛评分法(VAS)评估镇痛效果,并采用酶联免疫吸附法(ELISA)分别在术前、术毕、术后12 h、24 h、48 h测定2组患者血浆中促炎性细胞因子IL-6、TNF-α以及抗炎性细胞因子IL-4、IL-10的含量。镇痛组与对照组VAS评分、血浆中IL-6、TNF-α与IL-4、IL-10指标比较采用独立样本t检验,性别、ASA分级比较采用χ2检验。

结果

镇痛组患者在各时间点VAS评分均低于对照组,差异均有统计学意义(t=-3.218、-3.615、-1.458、-2.773、-0.483,P均<0.05)。对照组的IL-6、TNF-α及IL-4、IL-10的含量在术后12 h、24 h与48 h均高于镇痛组,差异均有统计学意义(IL-6:t=-3.556、-6.020、-3.471;TNF-α:t=-2.146、-3.874、-2.778;IL-4:t=-4.975、-2.322、-0.604;IL-10:t=-6.090、-4.340、-2.773,P均<0.05)。

结论

有效的镇痛可缓解外伤性脾切除术后的免疫损伤与炎症反应。

Objective

To observe the effects of post-splenectomy analgesia on cytokines in traumatic splenic rupture patients.

Methods

44 cases of traumatic splenic rupture patients who underwent splenectomy were randomized into two groups, analgesic group was being infused with sufentanil for postoperative analgesia, while the control group was being infused with normal saline. The analgesic effects of each group were recorded with visual analog score (VAS) andserum concentration of IL-6, TNF-α, IL-4, and IL-10 were measured by ELISA before operation, after operation, at postoperative 12 h, postoperative 24 h, and postoperative 48 h in both groups.

Results

The VAS were lower than in the control group at each evaluating time point (t=-3.218, -3.615, -1.458, -2.773, -0.483, all P<0.05). Serum concentration of IL-6, TNF-α, IL-4, and IL-10 in the control group in time point postoperative 12 h, postoperative 24 h, and postoperative 48 h were higher than those in the analgesia group (IL-6: t=-3.556, -6.020, -3.471; TNF-α: t=-2.146, -3.874, -2.778; IL-4: t=-4.975, -2.322, -0.604; IL-10: t=-6.090, -4.340, -2.773, all P<0.05).

Conclusion

Effective analgesia can alleviate immune injury and inflammation after splenectomy in traumatic splenic rupture patients.

表1 镇痛组与对照组患者一般情况比较
表2 镇痛组与对照组术后各时间点VAS评分(±s
表3 镇痛组与对照组患者血浆IL-6水平比较(μ g/L,±s
表4 镇痛组与对照组患者血浆TNF-α水平比较(μ g/L,±s
表5 镇痛组与对照组患者血浆IL-4水平比较(μ g/L,±s
表6 镇痛组与对照组患者血浆IL-10水平比较(μ g/L,±s
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