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目的:观察非甾体消炎镇痛药氯诺昔康超前镇痛对胃癌患者术后血浆皮质醇浓度的影响。方法:Ⅰ组15例术前给予氯诺昔康8 mg,手术后经PCA泵以氯诺昔康和吗啡镇痛;Ⅱ组15例仅在术后经PCA泵给予吗啡镇痛。分别于术前、术毕、术后24 h、术后72 h抽取外周血,测定血浆皮质醇(Cor)浓度。结果:两组患者术后VAS评分差异无统计学意义。与术前值比较,Ⅱ组患者术毕、术后24 h时血浆皮质醇水平升高,Ⅰ组血浆皮质醇水平仅在术毕时高于术前(P<0.05)。与Ⅱ组相比,Ⅰ组术毕、术后24 h血浆皮质醇水平明显降低(P<0.05)。结论:氯诺昔康超前镇痛能减轻皮质醇的增高程度,减轻胃癌患者术后的过度应激状态。
Objective: To observe the effect of preoperative analgesia of lonoxicam, a non-steroidal anti-inflammatory analgesic, on postoperative plasma cortisol in patients with gastric cancer. Methods: Fifteen patients in group Ⅰ received preoperative lornoxicam 8 mg. After operation, lornoxicam and morphine were administered by PCA pump. Fifteen patients in group Ⅱ received only morphine analgesia via PCA pump after operation. Peripheral blood was drawn before surgery, at the end of surgery, 24 h after operation, and 72 h after operation. Plasma Cortisol (Cor) concentration was measured. Results: There was no significant difference in postoperative VAS score between the two groups. Compared with the preoperative value, the level of plasma cortisol increased in group Ⅱ after operation, and the level of plasma cortisol in group Ⅰ was higher than that before operation (P <0.05). Compared with group Ⅱ, the level of plasma cortisol in group Ⅰ was significantly decreased (P <0.05) 24 h after operation. Conclusion: Lornoxicam preemptive analgesia can reduce the increase of cortisol and alleviate the postoperative over-stress status of gastric cancer patients.