[關(guān)鍵詞]
[摘要]
目的 探究普瑞巴林膠囊對(duì)腰椎間盤突出微創(chuàng)術(shù)患者術(shù)后疼痛及血清腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素-6(IL-6)水平的影響。方法 選取2014年1月-2018年1月于延安大學(xué)附屬醫(yī)院進(jìn)行微創(chuàng)治療的138例腰椎間盤突出患者為研究對(duì)象,按照隨機(jī)數(shù)字表法將其分為對(duì)照組和實(shí)驗(yàn)組,每組各69例。對(duì)照組患者于麻醉實(shí)施2 h前服用塞來(lái)昔布膠囊0.4g,術(shù)后對(duì)照組患者每12 h服用一次塞來(lái)昔布膠囊進(jìn)行鎮(zhèn)痛,每次服用劑量為0.2 g;實(shí)驗(yàn)組患者麻醉前服用普瑞巴林膠囊200 mg,術(shù)后每12 h服用一次普瑞巴林膠囊進(jìn)行鎮(zhèn)痛,服用劑量為150 mg/次。比較兩組患者靜息痛及活動(dòng)痛VAS評(píng)分、血清炎性因子水平和遠(yuǎn)期隨訪3個(gè)月內(nèi)的神經(jīng)性病理疼痛發(fā)生率。結(jié)果 術(shù)后,兩組VAS評(píng)分均有所下降,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),且實(shí)驗(yàn)組患者術(shù)后12、24、72 h靜息痛及活動(dòng)痛VAS評(píng)分均低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。術(shù)后72 h兩組TNF-α、IL-6水平均有所下降,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);同時(shí)實(shí)驗(yàn)組血清因子水平顯著低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。術(shù)后3個(gè)月隨訪示實(shí)驗(yàn)組神經(jīng)性病理疼痛發(fā)生率低于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 普瑞巴林膠囊能夠有效緩解腰椎間盤突出微創(chuàng)術(shù)患者術(shù)后疼痛,同時(shí)降低其血清TNF-α、IL-6水平,且遠(yuǎn)期隨訪效果較好,值得進(jìn)行臨床推廣使用。
[Key word]
[Abstract]
Objective To explore the effect of Pregabalin Capsules on postoperative pain and serum TNF-α and IL-6 in patients with minimally invasive surgery for lumbar intervertebral disc herniation. Methods Patients (138 cases) with lumbar intervertebral disc herniation treated by minimally invasive therapy in Yan'an University Affiliated Hospital from January 2014 to January 2018 were selected as the research object. According to the random digital table method, the patients were divided into control and experimental groups, with 69 patients in each group. Patients in the control group were po administered with Celecoxib Capsules 0.4 g before 2 h of the anesthesia, and patients in the control group were given Celecoxib Capsules every 12 hours after operation for analgesia, at a dose of 0.2 g. Patients in the experimental group were treated with Pregabalin Capsules 200 mg before anesthesia, and the control group was treated with Pregabalin Capsules every 12 hours after operation for analgesia, the dosage was 150 mg/time. The VAS score of resting and active pain, the level of serum inflammatory factors, and the incidence of neuropathic pain within 3 months of long-term follow-up were compared between the two groups. Results After operation, the VAS scores in two groups were decreased, and the difference was statistically significant in the same group (P<0.05). And the VAS scores of resting pain and active pain in the experimental group were lower than those in the control group at 12, 24 and 72 h after operation, with significant difference between two groups (P<0.05). At 72 h after operation, the levels of TNF-a and IL-6 in two groups were decreased, and the difference was statistically significant in the same group (P<0.05). At the same time, the level of serum factor in the experimental group was significantly lower than that in the control group, with significant difference between two groups (P<0.05). At 3 months after operation, the incidence of neuropathic pain in the experimental group was lower than that of the control group, and there were differences between two groups (P<0.05). Conclusion Pregabalin Capsules can effectively alleviate postoperative pain in patients with lumbar intervertebral disc herniation, and reduce the level of serum TNF-α and IL-6, and the long-term follow-up effect is better, which has a certain clinical application value.
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