目的:研究诱导前帕瑞昔布钠干预对骨科手术后切口疼痛、炎症应激反应的影响.方法:选择绵阳市中心医院2015年3月～2017年6月期间进行腰麻联合硬膜外阻滞麻醉下骨科手术的患者,采用随机数表法将其分为两组,Par组接受诱导前帕瑞昔布钠干预联合常规术后静脉自控镇痛,对照组仅接受常规术后静脉自控镇痛.手术前后测定血清及外周血中的疼痛神经递质、炎症分子及应激分子的含量.结果:与组内手术前疼痛神经递质比较,两组患者手术后1天、手术后3天时血清中PGE2 、5-H T 、SP 、NPY的含量均显著降低,血清中COR 、GH的含量以及外周血中JAK2 、STAT3 、IL-1 、IL-6 、IFIT1 、Nrf2 、HO-1的mRNA表达量显著升高且 Par组患者手术后1 d 、手术后3 d时血清中 PGE2 、5-HT 、SP 、NPY 、COR 、GH的含量以及外周血中JAK2 、STAT3 、IL-1 、IL-6 、IFIT1 、Nrf2 、HO-1的mRNA 表达量低于对照组.结论:诱导前帕瑞昔布钠干预能够减轻骨科手术后的切口疼痛及炎症应激反应.%Objective :To study the effect of parecoxib sodium intervention before induction on incision pain and inflam-matory stress response after orthopedic surgery .Methods :Patients who underwent orthopedic surgery under lumbar anesthesia combined with epidural block anesthesia in Mianyang Central Hospital between March 2015 and June 2017 were selected and di-vided into two groups by random number table method ,Par group received parecoxib sodium intervention before induction combined with routine postoperative patient-controlled intravenous analgesia ,and control group only accepted routine postoper-ative patient-controlled intravenous analgesia .The pain neurotransmitters ,inflammatory molecules and stress molecules in ser-um and peripheral blood were measured before surgery as well as 1 day and 3 days after surgery .Results :Compared with pain neurotransmitters of same group before surgery ,serum PGE2 ,5-HT ,SP ,NPY levels of both groups were significantly lower whereas serum COR and GH levels and peripheral blood JAK 2 ,STAT3 ,IL-1 ,IL-6 ,IFIT1 ,Nrf2 and HO-1 mRNA expres-sion were significantly higher 1 day and 3 days after surgery ,and serum PGE2 ,5-HT ,SP ,NPY ,COR and GH levels as well as peripheral blood JAK2 ,STAT3 ,IL-1 ,IL-6 ,IFIT1 ,Nrf2 and HO-1 mRNA expression of Par group 1 day and 3 days after surgery were lower than those of control group .Conclusion :parecoxib sodium intervention before induction can reduce the inci-sion pain and inflammatory stress response after orthopedic surgery .
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