[1]杨天庶　李梅花　谭国政　李　锋.多模式镇痛应用于下肢骨折术后的镇痛效果及对炎性、免疫功能的影响[J].大众科技,2021,23(11):57-60.
　The Analgesic Effect of Multi-Mode Analgesia ofter Lower Limb Fractures and Its Effect on Inflammatory and Immune Function[J].Popular Science & Technology,2021,23(11):57-60.
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多模式镇痛应用于下肢骨折术后的镇痛效果及对炎性、免疫功能的影响()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
23
期数:
2021年11
页码:
57-60
栏目:
医药与卫生
出版日期:
2021-11-20

文章信息/Info

Title:
The Analgesic Effect of Multi-Mode Analgesia ofter Lower Limb Fractures and Its Effect on Inflammatory and Immune Function
作者:
杨天庶　李梅花　谭国政　李　锋　
（梧州市中医医院，广西 梧州 543000）
关键词:
芬太尼; 静脉自控镇痛; 硬膜外; 蛛网膜下腔阻滞; 下肢骨折术; 镇痛效果; 炎性; 免疫功能
Keywords:
Fentanyl intravenous controlled analgesia epidural subarachnoid block lower limb fracture analgesic effect inflammatory immune function
文献标志码:
A
摘要:
目的：对比芬太尼静脉自控镇痛模式与硬膜外联合蛛网膜下腔阻滞镇痛模式应用于下肢骨折术后的镇痛效果及对炎性、免疫功能的影响。方法：选取2018年8月至2020年2月于梧州市中医医院接受治疗的101例下肢骨折手术患者为研究对象，以随机数字表法分为两组，甲组行芬太尼静脉自控镇痛（单一镇痛模式），乙组行硬膜外联合蛛网膜下腔阻滞镇痛（多模式镇痛），对比两组术后不同时间点的视觉模拟疼痛（Visual analogue pain score，VAS）评分、手术前后免疫功能指标（CD4+、CD8+和 CD4+/CD8+）、炎性因子[白细胞介素-6（Interleukin-6，IL-6）、肿瘤坏死因子-a（Tumor necrosis factor-a，TNF-α）]变化情况。结果：与甲组比较，乙组术后12 h、术后24 h与术后48 h时VAS评分均更低（P＜0.05）；术后24 h、48 h时，乙组CD4+、CD4+/CD8+均高于甲组（P＜0.05）；术后24 h、48 h时，乙组IL-6、TNF-α浓度均低于甲组（P＜0.05）。结论：硬膜外联合蛛网膜下腔阻滞镇痛模式应用于下肢骨折术后的镇痛效果理想，优于芬太尼静脉自控单一镇痛模式，且能改善机体炎症因子水平与免疫功能。
Abstract:
Objective: To compare the analgesic effect of Fentanyl intravenous controlled analgesia mode and epidural combined subarachnoid block analgesia mode in the postoperative treatment of lower limb fractures and its effects on inflammatory and immune function. Methods: A total of 101 patients with lower limb fracture surgery who received treatment in Wuzhou Hospital of Traditional Chinese Medicine from August 2018 to February 2020 were selected as the research objects. They were divided into two groups by random number table method. Group A received Fentanyl intravenous controlled analgesia (single analgesia mode), group B received epidural combined subarachnoid block analgesia (multi-mode analgesia). Visual analog pain score (VAS), immune function indexes (CD4 +, CD8 + and CD4 + / CD8 +), inflammatory factor [interleukin-6 (IL-6), tumor necrosis factor-a, (TNF-α) were compared between the two groups at different time points after operation. Results: Compared with group A, VAS scores in group B were lower at 12 h, 24 h and 48 h after operation (P < 0.05) CD4 +, CD4 + / CD8 + in group B were higher than those in group A at 24 h and 48 h after operation (P < 0.05) The concentrations of IL-6 and TNF-α in group B were lower than those in group A at 24 h and 48 h after operation (P < 0.05). Conclusion: Epidural combined subarachnoid block analgesia mode has ideal analgesic effect after lower limb fracture surgery, which is superior to Fentanyl intravenous controlled single analgesia mode, and can improve the level of inflammatory factors and immune function.

参考文献/References:

[1]　叶海啸. 多模式镇痛对下肢骨折患者术后疼痛炎性因子及免疫功能的影响[J]. 基层医学论坛，2018，22(17): 2377-2378. [2]　莫云达，罗雅幸，陈昱. 多模式镇痛对下肢骨折术后患者免疫功能，炎性因子及疼痛程度的影响[J]. 临床和实验医学杂志，2021，12(20): 437-440. [3]　陈鹏，周本宏，陈富超，等. 地佐辛联合氟比洛芬酯与单用舒芬太尼在术后静脉自控镇痛中有效性与安全性的meta分析[J]. 中南药学，2019，17(2): 186-191. [4]　陈小云，李思盈. 超声引导下腹横肌平面阻滞复合氟比洛芬酯或舒芬太尼在剖宫产术后镇痛中的应用效果[J]. 广西医科大学学报，2019，36(4): 621-624. [5]　吴建航，黄维文，刘荣，等. 氟比洛芬酯复合不同剂量的舒芬太尼用于骨科手术术后镇痛的效果观察[J]. 中国医院用药评价与分析，2019，19(8): 965-967. [6]　吴安林，艾珏萍，谢秀惠，等. 推拿对骨骼肌损伤组织机化期TGF-β1，IL-6及TNF-α的影响[J]. 湖南中医杂志，2020，36(2): 142-144.

备注/Memo

备注/Memo:
【收稿日期】2021-09-07 【作者简介】杨天庶（1985－）男，广西桂平人，梧州市中医医院主治医师，研究方向为临床麻醉。
更新日期/Last Update: 2022-02-14