盐酸羟考酮注射液超前镇痛对腹腔镜胆囊切除术患者血清炎性因子、神经递质指标及免疫功能的影响

摘要

目的:探讨盐酸羟考酮注射液超前镇痛对腹腔镜胆囊切除术患者血清炎性因子、神经递质指标及免疫功能的影响.方法:113例行腹腔镜胆囊切除术患者依据随机数据表法分为对照组(n=57)和观察组(n=56),对照组患者给予枸橼酸舒芬太尼注射液镇痛,观察组给予盐酸羟考酮注射液镇痛,比较术前及术后1d两组血清炎性因子[血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)],神经递质指标[5-羟色胺(5-HT),P物质]及免疫功能[CD4+、CD8+、CD4+/CD8+]变化.结果:术前,两组间TNF-α、IL-6、5-HT、P物质、CD4+、CD8+、CD4+/CD8+水平比较,差异无统计学意义(P>0.05).与组内术前水平相比,术后1d两组TNF-α、IL-6、5-HT、P物质、CD8+水平均明显升高,且观察组明显低于对照组,差异比较有显著性(P<0.05);两组术后1dCD4+、CD4+/CD8+水平均显著低于组内术前水平,且观察组水平明显高于对照组,差异比较有显著性(P<0.05).结论:腹腔镜胆囊切除术患者盐酸羟考酮注射液超前镇痛可有效减少血清炎性因子及神经递质指标的释放,改善机体免疫功能,具有重要临床价值.%Objective:To investigate the effect of oxycodone hydrochloride injection preemptive analgesia on serum in-flammatory factors,neurotransmitter index and immune function in patients with laparoscopic cholecystectomy.Methods:Ac-cording to random data table,113 patients undergoing laparoscopic cholecystectomy were divided into control group (n =57) and observation group (n =56),patients in the control group were treated with sufentanil citrate injection analgesia,and the observation group patients were given oxycodone hydrochloride injection analgesia,the levels of serum inflammatory factors [tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6 )],neurotransmitter index [5-hydroxy tryptamine (5-HT),P sub-stance]and immune function index [CD4 + ,CD8 + ,CD4 +/CD8 + ]of two groups between preoperative and postoperative 1 d were compared.Results:There were no significant differences in levels of TNF-α,IL-6,5-HT,P substance,CD4 + ,CD8 + and CD4 +/CD8 + between the two groups preoperative (P >0.05).Compared with the levels of the same group preoperative,post-operative 1 d,the levels of TNF-α,IL-6,5-HT,P substance,CD8 + were significantly increased,and levels in the observation group were significantly lower compared with the control group,the difference was statistically significant (P <0.05);Postop-erative 1 d,the levels of CD4 + ,CD4 +/CD8 + in the two groups were significantly lower than the preoperative level within the group,and the observation group was significantly higher than the control group (P <0.05 ).Conclusion:Oxycodone hydro-chloride injection preemptive analgesia in laparoscopic cholecystectomy can effectively reduce serum inflammatory factors and neurotransmitter index release,improve immune function,has an important clinical value.