【摘要】：目的探討氫嗎啡酮對(duì)婦科腹腔鏡手術(shù)患者圍術(shù)期應(yīng)激因子和炎性因子水平的影響。方法選擇2015年1—12月紹興市婦幼保健院全麻下行婦科腹腔鏡手術(shù)患者100例作為研究對(duì)象,隨機(jī)將其分為氫嗎啡酮組和芬太尼組,每組各50例。ELISA法測(cè)定血清皮質(zhì)醇、去甲腎上腺素、腎上腺素、C反應(yīng)蛋白、腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素-10(IL-10)和白細(xì)胞介素-6(IL-6)水平。結(jié)果與入室5 min比較,2組患者插管時(shí)平均動(dòng)脈壓和心率升高(P0.05),芬太尼組拔管后10 min平均動(dòng)脈壓和心率降低(P0.05);和芬太尼組比較,氫嗎啡酮組拔管后10 min平均動(dòng)脈壓和心率升高(P0.05)。與入室5 min比較,2組插管時(shí)甲腎上腺素、腎上腺素水平升高(P0.05),皮質(zhì)醇水平降低(P0.05),拔管后10 min芬太尼組去甲腎上腺素水平升高(P0.05);與芬太尼組比較,氫嗎啡酮組插管時(shí)去甲腎上腺素和腎上腺素水平降低(P0.05),皮質(zhì)醇水平升高(P0.05)。與入室5 min比較,2組手術(shù)30 min、手術(shù)結(jié)束、術(shù)后1 h的TNF-α和IL-6水平升高(P0.05),2組手術(shù)結(jié)束和術(shù)后1 h的IL-10水平升高(P0.05);與芬太尼組比較,氫嗎啡酮組手術(shù)30 min、手術(shù)結(jié)束、術(shù)后1 h的TNF-α和IL-6水平降低(P0.05),手術(shù)結(jié)束和術(shù)后1 h的IL-10水平升高(P0.05)。結(jié)論氫嗎啡酮用于全麻婦科腹腔鏡手術(shù),圍手術(shù)期血流動(dòng)力學(xué)較穩(wěn)定,可減輕圍手術(shù)期應(yīng)激反應(yīng)和炎癥反應(yīng)。
[Abstract]:Objective to investigate the effect of hydromorphine on perioperative stress factors and inflammatory factors in patients undergoing gynecologic laparoscopic surgery. Methods from January to December 2015, 100 patients undergoing gynecological laparoscopic surgery under general anesthesia in Shaoxing Maternal and Child Health Hospital were randomly divided into hydromorphine group and fentanyl group, 50 cases in each group. Serum cortisol was determined by ELISA method. Norepinephrine, C-reactive protein, tumor necrosis factor- 偽 (TNF- 偽), interleukin-10 (IL-10) and interleukin-6 (IL-6). Results compared with 5 min, the mean arterial pressure and heart rate increased during intubation in both groups (P0.05), and decreased 10 min after extubation in fentanyl group (P0.05). Compared with fentanyl group, the mean arterial pressure and heart rate increased 10 min after extubation in hydromorphine group (P0.05). Compared with 5 min, the levels of epinephrine and adrenaline increased (P0.05), cortisol decreased (P0.05), and noradrenaline increased 10 min after extubation in fentanyl group (P0.05). Compared with fentanyl group, norepinephrine and epinephrine levels were decreased and cortisol levels were increased in hydromorphine group (P0.05). Compared with 5 min after operation, the levels of TNF- 偽 and IL-6 increased 1 hour after operation in both groups (P0.05), and IL-10 level increased at 1 hour after operation in both groups (P0.05). Compared with fentanyl group, the levels of TNF- 偽 and IL-6 in hydromorphine group decreased 1 h after 30 min, operation (P0.05), and IL-10 level increased at 1 h after operation (P0.05). Conclusion the hemodynamics of hemodynamics in general anesthesia and gynecologic laparoscopic surgery is stable, and the stress and inflammation can be alleviated during the perioperative period.
【作者單位】： 紹興市婦幼保健院麻醉科;浙江省人民醫(yī)院產(chǎn)科;
【基金】：2014浙江省醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2014KYB033)
【分類號(hào)】：R614

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