[1]饶新仪.腰硬联合麻醉髋关节置换术后患者疼痛及炎症细胞因子的影响研究[J].陕西医学杂志,2019,(7):876-878,881.
　Rao Xinyi..The effect of combined lumbar and anesthesia on pain and inflammatory cytokines after hip arthroplasty[J].,2019,(7):876-878,881.
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腰硬联合麻醉髋关节置换术后患者疼痛及炎症细胞因子的影响研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年7期
页码:
876-878,881
栏目:
临床研究
出版日期:
2019-07-05

文章信息/Info

Title:
The effect of combined lumbar and anesthesia on pain and inflammatory cytokines after hip arthroplasty
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.07.017
作者:
饶新仪
成都市第五人民医院麻醉科(成都 611130)
Author(s):
Rao Xinyi.
Department of Anesthesiology,Chengdu Fifth People’s Hospital(Chengdu 611130)
关键词:
腰硬联合麻醉; 髋关节置换术; 镇痛; 白细胞介素-6; 白细胞介素-10; 肿瘤坏死因子
Keywords:
Key words Combined lumbar and anesthesia;  Hip replacement;  Analgesia;  IL-6;  IL-10;  TNF-α
分类号:
R614
文献标志码:
A
摘要:
摘 要 目的：探讨腰硬联合麻醉对髋关节置换术后疼痛及炎症细胞因子的影响。方法：选择行髋关节置换术患者78例，随机分为对照组和观察组。对照组给予全身麻醉，观察组给予腰硬联合麻醉。比较两组患者的疼痛和镇静程度评分，记录治疗前后患者的血清中白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平，以及观察术后麻醉相关指标和不良反应情况。结果：对照组麻醉起效时间、麻醉用药以及清醒时间明显高于观察组；观察组的不良反应18例（其中恶心呕吐6例、低血压8例、呼吸抑制1例、疼痛3例），发生率为42.86%，明显低于对照组（24例），其中恶心呕吐8例、低血压10例、呼吸抑制2例、疼痛4例，发生率66.67%）；上述数据相比较，差异均具有统计学意义（P＜0.05）；术后1、2 h后，观察组VAS疼痛评分明显低于对照组，Ramsay镇静评分明显高于对照组，上述相比较，差异均有统计学意义（P＜0.05）；手术前两组IL-6、IL-10、TNF-α比较，差异不显著，不具有统计学意义（P＞0.05）；手术后观察组IL-6、TNF-α水平明显低于对照组，IL-10水平明显高于对照组，上述比较差异均有统计学意义（P＜0.05）。 结论：腰硬联合麻醉术对髋关节置换术可有效缓解术后疼痛，同时能调节和维持炎症细胞因子水平平衡，且术后不良反应少。
Abstract:
Abstract Objective：To investigate the effect of combined lumbar and anesthesia on pain and inflammatory cytokines after hip arthroplasty. Methods：Eighty-six hip arthroplasty patients were randomly divided into control group and observation group. The control group was given general anesthesia，and the observation group was given combined spinal and epidural anesthesia. The scores of pain and sedation were compared between the two groups. The levels of IL-6，TNF-α and IL-10 in the serum of the patients before and after treatment were recorded，and the postoperative anesthesia effects and adverse reactions were observed. Results：The anesthesia onset time，anesthetic medication and waking time in the control group were significantly higher than those in the observation group; 18 cases of adverse reactions in the observation group (including nausea and vomiting 6，hypotension 8，respiratory depression 1，pain 3)，the incidence rate was 42.86%. Lower than the control group (24 cases，including nausea and vomiting 8，hypotension 10，respiratory depression 2，pain 4，incidence rate 66.67%); the above data were compared，the difference was statistically significant (P ＜0.05); After 2 h，the VAS pain score of the observation group was significantly lower than that of the control group，and the Ramsay sedation score was significantly higher than that of the control group. The difference was statistically significant (P＜0.05); the preoperative group IL-6，IL -10，TNF-α comparison，the difference was not significant，not statistically significant (P＞0.05); the level of IL-6 and TNF-α in the observation group was significantly lower than that in the control group，and the IL-10 level was significantly higher than the control group. The above differences were statistically significant (P＜0.05).Conclusion：Lumbar-sparing combined anesthesia for hip replacement surgery can effectively relieve postoperative pain，at the same time can regulate and maintain the balance of inflammatory cytokines，and postoperative adverse reactions are worthy of clinical promotion.

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更新日期/Last Update: 2019-07-12