地塞米松应用时机对硬膜外麻醉术后腰痛与炎性细胞因子的影响

摘要

目的 探讨地塞米松应用时机对硬膜外麻醉术后腰痛与炎性细胞因子的影响.方法 选取120例硬膜外麻醉下剖宫产分娩术麻醉穿刺过程中出现神经根损伤患者为研究对象,根据是否应用地塞米松及应用时间分为A组、B组、C组(对照组).观察各组患者术后24、48、72 h时神经根刺激症状及炎性细胞水平改变情况.结果 三组患者神经根刺激症状于术后24、48、72 h比较,A组与B组均优于C组,差异有统计学意义(P<0.05),A组与B组比较差异无统计学意义(P>0.05);术后C组各时间点血清肿瘤坏死因子-α(T NF-α)、白细胞介素(IL)-1β、IL-6水平均高于 A、B组,差异有统计学意义(P<0.05);A 组术后24、48、72 h血清T NF-α、IL-1β、IL-6水平低于B组,差异有统计学意义(P<0.05).结论 地塞米松治疗剖宫产手术硬膜外穿刺神经根损伤具有良好临床疗效,神经根损伤后早期应用临床效果更佳.%Objective To investigate the effect of dexamethasone use timing on lumbar pain after epidural anesthesia operation and inflammatory factors.Methods One hundred and twenty cases of cesarean section under epidural anesthesia appearing nerve root injury during the anesthetic puncture process were selected as the research subjects and divided into the group A,B and C(con-trol group)according whether using dexamethasone and use time.The changes of nerve root stimulation symptoms and inflammato-ry cells levels were observed at postoperative 24、48、72 h.Results The nerve root stimulation symptoms in 3 groups had a certain difference among postoperative 24、48、72 h,the group A and group B were significantly better than the group C,the difference was statistically significant(P<0.05);the difference between the group A and B was not statistically significant(P>0.05);serum lev-els of TNF-α,IL-1β and IL-6 levels at various time points in the group C were higher than those in the group A and group B,the difference was statistically significant(P<0.05).Serum levels of TNF-α,IL-1β and IL-6 levels at postoperative 24,48,72 h in the group A were lower than those in the group B,the difference was statistically significant(P<0.05).Conclusion Dexamethasone for treating epidural puncturing nerve root injury in cesarean section has good clinical curative effect,and earlier application after nerve root injury has better clinical efficacy.