丁丙诺啡透皮贴剂联合静脉自控镇痛对老年股骨转子间骨折患者血清疼痛相关生化指标的影响

摘要

Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intrave-nous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture.Methods:A to-tal of 92 elderly patients with intertrochanteric fracture who received surgical treatment in the hospital were collected and divid-ed into control group (n = 46 )and observation group (n = 46 )according to the random number table method.The control group received patient-controlled intravenous analgesia,and the observation group received buprenorphine transdermal patch combined with patient-controlled intravenous analgesia.Differences in serum levels of inflammatory factors,oxidative stress indexes and pain mediators of two groups of patients were detected before and 24 h after surgery.Results:Differences in serum levels of inflammatory factors,oxidative stress indexes and pain mediators were not statistically significant between the two groups before surgery;24 h after surgery,serum IL-1β,IL-6,IL-8,TNF-α,MDA,SP,PGE2,5-HT,HA and NPY levels of both groups of patients increased significantly,while SOD,TAC and CAT levels decreased significantly,and serum IL-1β, IL-6,IL-8,TNF-α,MDA,SP,PGE2,5-HT,HA and NPY levels of observation group were lower than those of control group,while SOD,TAC and CAT levels were higher than those of control group.Conclusion:Buprenorphine transdermal patch combined with patient-controlled intravenous analgesia can effectively inhibit the expression of pain-related indexes and relieve early postoperative pain intensity in elderly patients with intertrochanteric fracture.%目的:探讨丁丙诺啡透皮贴剂联合静脉自控镇痛对老年股骨转子间骨折患者血清疼痛相关生化指标的影响.方法:收集在本院接受手术治疗的老年股骨转子间骨折患者92例,随机分为对照组、观察组各46例.对照组患者接受静脉自控镇痛,观察组患者接受丁丙诺啡透皮贴剂联合静脉自控镇痛.术前、术后24h,测定两组血清中炎症因子、氧化应激指标、疼痛介质含量的差异.结果:两组术前血清中炎症因子、氧化应激指标、疼痛介质含量的差异无统计学意义;术后24h,两组血清中IL-1β、IL-6、IL-8、TNF-α、MDA、SP、PGE2、5-HT、HA、NPY的含量均显著升高,SOD、TAC、CAT的含量均显著降低,且观察组患者血清中IL-1β、IL-6、IL-8、TNF-α、MDA、SP、PGE2、5-HT、HA、NPY的含量低于对照组,SOD、TAC、CAT的含量高于对照组.结论:老年股骨转子间骨折患者接受丁丙诺啡透皮贴剂联合静脉自控镇痛,可有效抑制疼痛相关指标的表达、缓解术后早期疼痛剧烈程度.