氟比洛芬酯对肝硬化患者术后镇痛和认知功能的影响

doi:10.20047/j.issn1673-7210.2023.01.21

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摘要目的研究氟比洛芬酯对肝硬化患者术后镇痛和认知功能的影响。方法选取2020年7月至2021年12月江苏省徐州市中心医院行手术治疗的60例肝硬化患者。依据随机数字表法将其分为观察组、对照组，每组30例。观察组切皮前给予氟比洛芬酯20 mg，术毕接静脉自控镇痛泵（氟比洛芬酯2.00 mg/kg＋地佐辛0.50 mg/kg +帕罗诺司琼0.15 mg，加生理盐水至100 ml）；对照组术毕接静脉自控镇痛泵（地佐辛0.50 mg/kg＋帕罗诺司琼0.15 mg，加生理盐水至100 ml）。比较两组术前24 h（T1）、术后24 h（T3）、术后48 h（T4）时简易智能神经状态检查量表（MMSE）评分；比较两组术后12 h（T2）、T3、T4时视觉模拟评分法（VAS）评分；比较两组术前（Ta）、术毕（Tb）、T3时白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平，记录两组术后48 h内不良反应发生情况。结果两组T1、T3、T4时MMSE评分比较，差异无统计学意义（P＞0.05）。T2、T3、T4时，观察组VAS评分低于对照组，差异有统计学意义（P＜0.05）。两组Ta、Tb、T3时IL-6和TNF-α水平比较，差异无统计学意义（P＞0.05）。两组术后48 h内POCD发生率比较，差异无统计学意义（P＞0.05）。两组术后48 h内不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论氟比洛芬酯超前镇痛及其复合地佐辛应用于术后镇痛效果满意，可减轻肝硬化患者术后疼痛，未观察到氟比洛芬酯对肝硬化患者认知功能及炎症水平的影响。

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	刘莹1 王露2 张雪迪3 闫家微3 杨静茹1 王立伟1

关键词 ：氟比洛芬酯, 肝硬化, 镇痛, 术后认知功能障碍

Abstract：Objective To study the effects of Flubiprofen Axetil on postoperative analgesia and cognitive function in cirrhosis patients. Methods A total of 60 cirrhosis patients who underwent surgical treatment in Xuzhou Central Hospital of Jiangsu Province from July 2020 to December 2021 were selected. According to the random number table method, they were divided into observation group and control group, with 30 cases in each group. Before the surgery, the observation group was given 20 mg Flurbiprofen Axetil, followed by intravenous controlled analgesia pump (Flurbiprofen Axetil 2.00 mg/kg+Desoxine 0.50 mg/kg+ Paronosetron 0.15 mg, plus normal saline to 100 ml); control group was given an intravenous analgesic pump (Desoxine 0.50 mg/kg+ Paronosetron 0.15 mg, plus normal saline to 100 ml). The scores of mini-mental state examination (MMSE) were compared between two groups at 24 h preoperative (T1), 24 h postoperative (T3), and 48 h postoperative (T4); visual analog scale (VAS) scores at 12 h postoperative (T2), T3, and T4 were compared between two groups; the levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were compared between two groups before surgery (Ta), after surgery (Tb) and T3, and the occurrence of adverse reactions within 48 h after surgery were recorded between two groups. Results There were no significant differences in the scores of MMSE at T1, T3, and T4 between two groups (P＞0.05). The scores of VAS at T2, T3, and T4 of observation group were lower than those of control group, and the differences were statistically significant (P＜0.05). There were no significant differences in the levels of IL-6 and TNF-α at Ta, Tb, and T3 between two groups (P＞0.05). There was no significant difference in the incidence of POCD between two groups within 48 h after surgery (P＞0.05). There was no significant difference in the total incidence of adverse reactions between two groups within 48 h after surgery (P＞0.05). Conclusion Flubiprofen Axetil and its combination of Desosxin are satisfactory for postoperative analgesia and can reduce postoperative pain in cirrhosis patients. No effect of Flulofenen Axetil on cognitive function and inflammation level in cirrhosis patients are observed.

Key words： Flubilofenen Axetil Cirrhosis Analgesia Postoperative cognitive dysfunction

基金资助:江苏省卫生计生委医学科研课题（苏卫科教﹝2018﹞ 14号-48）。

通讯作者: 王立伟（1973.8-），男，博士，主任医师，江苏省徐州市中心医院麻醉一科主任，硕士生导师；研究方向：麻醉术后认知功能障碍机制及治疗、疼痛机制及治疗。

作者简介: 刘莹（1988.2-），女，徐州医科大学研究生院2019级麻醉专业在读硕士研究生；研究方向：麻醉术后认知功能障碍机制及治疗。

引用本文:

刘莹1 王露2 张雪迪3 闫家微3 杨静茹1 王立伟1. 氟比洛芬酯对肝硬化患者术后镇痛和认知功能的影响[J]. 中国医药导报, 2023, 20(1): 94-97,110.
LIU Ying1 WANG Lu2 ZHANG Xuedi3 YAN Jiawei3 YANG Jingru1 WANG Liwei1. Effects of Flubiprofen Axetil on postoperative analgesia and cognitive function in cirrhotic patients. 中国医药导报, 2023, 20(1): 94-97,110.

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