林浩,陈一林,孙振全,于淑霞,季娟,赵灵芝,张绍刚
LIN Hao,CHEN Yilin,SUN Zhenquan,YU Shuxia,JI Juan,ZHAO Lingzhi,ZHANG Shaogang

• 1:南京中医药大学附属南京市中西医结合医院麻醉科

摘要(Abstract)：

目的:探讨地佐辛对颈部淋巴结核手术麻醉前给药的镇痛效果及免疫功能的影响。方法:70例颈部淋巴结核术中采用静吸复合麻醉患者,根据麻醉诱导前给药均分为观察组和对照组,对照组患者麻醉诱导前给予氟比洛芬酯(50 mg),观察组则给予地佐辛(50 mg),分别于术后6、12及24 h时采用视觉模拟(VAS)评分评估2组患者的疼痛程度,Ramsay评分量表评估2组患者镇静情况;于麻醉前、手术完成时、术后12及24 h时检测2组患者外周血T淋巴细胞亚群中CD3~+、CD4~+、CD8~+及NK水平,同时观察镇痛期间的不良反应。结果:两组患者术后12和24 h时的VAS评分、Ramsay评分均低于术后6 h时(P<0.05),观察组术后6 h时的VAS评分低于对照组(P<0.05);与麻醉前比较,两组患者手术结束时和术后12 h时的CD3~+、CD4~+、NK水平均降低,观察组手术结束时和术后12 h时的CD8~+升高,术后24 h时的CD3~+、CD4~+、NK高于对照组(P<0.05);镇痛期间观察组的恶心呕吐、烦躁发生率均低于对照组(P<0.05)。结论:地佐辛用于颈部淋巴结核手术麻醉前给药的镇痛效果优于氟比洛芬酯,安全性高,对患者免疫功能影响小。
Objective:To study the effect of dezocine on analgesic effect and immune function before anaesthesia of cervical lymph node tuberculosis surgery.Methods:Seventy patients with cervical lymph node tuberculosis were divided into observation group and control group according to the administration of drugs before anesthesia induction.Patients in the control group were given 50 mg of flurbiprofen before anesthesia induction,while those in the observation group were given 50 mg of dezocine.The patients were assessed by visual analogue(VAS) score after 6,12 and 24 hours postoperatively to assess the degree of pain in the 2 groups,and the Ramsay scale was used to assess the sedation in the2 groups.Before anesthesia,at the end of operation and at 12 and 24 hours after operation,the levels of CD3 ~+,CD4 ~+,CD8 ~+ and NK in peripheral blood T lymphocyte subsets in both groups were detected,and the adverse reactions during analgesia were observed.Results:The VAS scores at 12 and24 hours after operation in both groups were lower than those at 6 hours after operation(P < 0.05) and the VAS score in the observation group was lower than that in the control group at 6 hours after operation(P < 0.05).Compared with those before anesthesia,the levels of CD3 ~+,CD4 ~+ and NK decreased at the end of operation and at 12 hours after operation in both groups; CD8 ~+ in observation group increased at the end of operation and at 12 hours after operation; CD3 ~+,CD4 ~+ and NK were higher than that of the control group at 24 hours after operation(P < 0.05); the incidence of nausea and vomiting during analgesia in the observation group was lower than that in the control group(P <0.05).Conclusion:The analgesic effect of dezocine before anaesthesia is better than that of flurbiprofen,and it is safe and has little effect on the immune function of patients.

关键词(KeyWords)： 结核;颈部淋巴;地佐辛;免疫功能;镇痛;镇静;效果
tuberculosis;cervical lymph node;dezocine;immune function;analgesia;composure;effect

Abstract:

Keywords:

基金项目(Foundation): 南京市卫生青年人才培养工程(QRX11103)

作者(Author): 林浩,陈一林,孙振全,于淑霞,季娟,赵灵芝,张绍刚
LIN Hao,CHEN Yilin,SUN Zhenquan,YU Shuxia,JI Juan,ZHAO Lingzhi,ZHANG Shaogang

DOI: 10.19367/j.cnki.1000-2707.2018.02.023

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