子宫肌瘤手术患者使用帕瑞昔布钠超前镇痛后的血清疼痛介质及机体免疫应答的评估

摘要

目的:研究子宫肌瘤手术患者使用帕瑞昔布钠超前镇痛后的血清疼痛介质及机体免疫应答情况.方法:选择2013年5月~2016年8月期间在惠州市第一妇幼保健院接受子宫肌瘤切除术的150例患者并随机分为两组,观察组患者接受术前帕瑞昔布钠超前镇痛联合常规全身麻醉,对照组患者接受常规全身麻醉.手术前后采集血清并测定疼痛介质、应激激素、体液免疫应答指标、细胞免疫应答指标的含量.结果:两组患者术后12、24、36、48 h时血清中前列腺素E2(PGE2)、β-内啡肽(β-EP)、SP、皮质醇(Cor)、胰岛素(Ins)、血管紧张素(Ang)-II、醛固酮(ALD)、γ-干扰素(IFN-γ)、白介素(IL)-17含量均显著高于术前,IgG、IgM、IgA、IL-4、IL-10含量均显著低于术前,且观察组患者术后12、24、36、48 h时血清中PGE2、β-EP、SP、Cor、Ins、Ang-II、ALD、IFN-γ、IL-17的含量均显著低于对照组,IgG、IgM、IgA、IL-4、IL10的含量均显著高于对照组.结论:子宫肌瘤手术患者使用帕瑞昔布钠超前镇痛能够减轻疼痛、抑制应激反应、改善免疫应答.%Objective: To study the serum pain medium and immune response of uterine fibroids surgery patients after parecoxib preemptive analgesia.Methods: A total of 150 cases of patients underwent uterine fibroid resection in gynecological department of the First Women and Children's Hospital in Huizhou during May 2013-August 2016 were enrolled and randomly divided into two groups, observation group patients received preoperative parecoxib sodium preemptive analgesia combined with general anesthesia, control group received routine general anesthesia.Serum was collected before and after operation, and the contents of pain mediators, stress hormones, humoral immune response and cellular immune response were determined.Results: Serum PGE2, β-EP, SP, Cor, Ins, Ang-II, ALD, IFN-γ, IL-17 contents of two groups after surgery were significantly higher than those before surgery, IgG, IgM, IgA, IL-4 and IL10 contents were significantly lower than those before surgery;serum PGE2, β-EP, SP, Cor, Ins, Ang-II, ALD, IFN-γ, IL-17 contents of observation group after surgery were significantly lower than those of control group, IgG, IgM, IgA, IL-4 and IL10 contents were significantly higher than those of control group.Conclusions: Usage of parecoxib sodium preemptive analgesia in uterine fibroids surgery can relieve pain, improve immunity, inhibit the stress response.