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舒芬太尼对老年下肢骨折患者炎症及疼痛介质的影响
袁卫国,李林佶,冯麟,谢颖,罗栩伟
0
(川北医学院第二临床医学院·南充市中心医院麻醉科;川北医学院第二临床医学院·南充市中心医院骨科)
摘要:
【摘要】〓目的〓观察舒芬太尼对老年下肢骨折患者炎症介质和疼痛介质的影响,为有效控制骨折疼痛提供临床依据。 方法〓选取2014年1月~2017年1月在南充市中心医院接受治疗的68例老年下肢骨折患者为研究对象,根据术后选择不同的止疼药物分为观察组与对照组,观察组25例患者使用舒芬太尼,对照组23例患者使用芬太尼,在术后24h和3d时比较两组患者的炎症介质因子白细胞介素2、6、10(IL2、IL6、IL10)及疼痛介质血清5羟色胺(5HT)、一氧化氮(NO)、前列腺素E2(PGE2)的变化。结果〓①术后24h和3d时两组患者的IL2、IL6、IL10指标水平均明显降低,而观察组降低更为明显(P<005)。②术后观察组患者的5HT、NO、PGE2表达水平逐渐降低并低于对照组(P<005)。结论〓老年骨折患者术后采用舒芬太尼镇痛可使患者的炎症介质和疼痛介质明显的降低,镇痛效果显著,维持机体内细胞因子的相对平衡,对减少术后应激反应有积极的作用。
关键词:  舒芬太尼  老年患者  下肢骨折  炎症介质  疼痛介质
DOI:
基金项目:四川省卫计委科研课题(16PJ201)
Study of the effects of sufentanil on inflammatory mediators and pain mediators in elderly patients with lower extremity fractures
YUAN Weiguo,LI linji,FENG Lin,XIE Ying,LUO Xuwei
(Department of Anesthesiology,Nanchong Central Hospital;Department of Orthopaedics, Nanchong Central Hospital)
Abstract:
【Abstract】〓Objective〓To observe the effect of sufentanil on the changes of inflammatory mediators and pain medium in elderly patients with lower limb fractures and provide clinical basis for effective control of fracture pain. Methods〓68 elderly patients with lower extremity fractures e treated in from January 2014 to January 2017 were retrospectively selected. The patients were divided into the observation group and the control group according to the choice of postoperative different analgesic drugs. The observation group (25 cases) was taken withsufentanil. The control group (23 patients) was treated with fentanyl. The changes of inflammatory mediators Interleukin (IL2,6,10), pain medium serum serotonin (5HT),Nitric oxide (NO), prostaglandin E2 (PGE2) levels in the two groups 24 hours and 3 days after surgery were compared.Results〓 The levels of IL2, IL6 and IL10 in patients with 24h and 3d were significantly decreased, and lower than those in the control group (P <005). The expression of 5HT, NO and PGE2 in the postoperative group was significantly decreased, and lower than that in the control group (P <005).Conclusion〓The use of sufentanil analgesia in elderly patients with fractures can significantly reduce the levels of inflammatory mediators and pain mediators, maintain the relative balance of cytokines in the body and has a positive effect in reducing the postoperative stress response.
Key words:  Sufentanil  Elderly patients  Lower extremity fractures  Inflammatory mediators  Pain medium

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