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Received:December 21, 2023 Published Online:August 20, 2024
Received:December 21, 2023 Published Online:August 20, 2024
中文摘要: 目的 探究胃肠肿瘤手术中应用不同剂量羟考酮麻醉对术后致痛物质水平、组织灌注及肠道屏障功能的影响。方法 选取2020年6月至2023年1月于六安市中医院接受手术治疗的45例胃肠肿瘤患者，随机分为3组，各15例。麻醉诱导过程中，A组予以0.08 mg/kg羟考酮，B组予以0.10 mg/kg羟考酮，C组予以0.12 mg/kg羟考酮。分别于麻醉诱导前（S1）、气管插管时（S2）、手术开始后30 min（S3）、术毕（S4）记录3组患者的血流灌注指数(PI)，于术前1 d及术后2 d检测致痛物质［5-羟色胺(5-HT)、P物质（SP）］水平，于术前1 d及术后2、4 d评估肠道屏障功能［二胺氧化酶（DAO）、D-乳酸、内毒素（ET）］，记录3组患者麻醉期间发生的不良反应情况。结果 S2、S3、S4时3组患者的PI水平较S1均升高，且A组高于B组、C组（P＜0.05）；术后2 d，3组患者的血清5-HT、SP水平较术前1 d均升高，且A组高于B组、C组（P＜0.05）；术后2、4 d，3组患者的血清DAO、D-乳酸、ET水平较术前1 d均降低，且A组低于B组、C组（P＜0.05）。麻醉期间，A组、B组、C组患者的不良反应总发生率（20.00%、26.67%、26.67%）相比差异无统计学意义(P＞0.05)。结论 相较于0.08 mg/kg或0.12 mg/kg的羟考酮，采用0.10 mg/kg的羟考酮进行麻醉可有效维持胃肠肿瘤手术患者术后的致痛物质、PI及肠道屏障功能的稳定性，且安全性较好。
Abstract:Objective To investigate the impact of different doses of oxycodone on postoperative levels of pain-causing substances, tissue perfusion, and intestinal barrier in patients undergoing gastrointestinal tumor surgery. Methods Forty-five patients with gastrointestinal tumors who underwent surgery at Lu'an Hospital of Traditional Chinese Medicine from June 2020 to January 2023 were selected and randomly divided into three groups, with 15 in each group. During the anesthesia process, group A received 0.08 mg/kg oxycodone, group B received 0.10 mg/kg oxycodone, and group C received 0.12 mg/kg oxycodone. The blood flow perfusion index (PI) was recorded at anesthesia induction (S1), endotracheal intubation (S2), 30 minutes after the start of surgery (S3), and at the end of surgery (S4). The levels of pain-causing substances ［5-hydroxytryptamine (5-HT) and substance P (SP)］ were detected 1 day before surgery and 2 days after surgery. The intestinal barrier function ［diamine oxidase (DAO), D-lactic acid, and endotoxin (ET)］ was assessed 1 day before surgery and 2 days and 4 days after surgery. Adverse reactions during anesthesia were recorded for the three groups. Results The PI levels of the three groups at S2, S3, and S4 were significantly higher than those at S1, and in group A was higher than in groups B and C (P＜0.05). On 2 days after surgery, the serum levels of 5-HT and SP in three groups were significantly higher than those before surgery, and in group A was higher than in groups B and C (P＜0.05). On 2 days and 4 days after surgery, the serum levels of DAO, D-lactic acid, and ET in three groups were significantly lower than those before surgery, and in group A was lower than in groups B and C (P＜0.05). The overall incidence of adverse reactions during anesthesia in groups A, B, and C (20.00%, 26.67%, 26.67%) showed no statistically significant difference (P＞0.05). Conclusion Compared to 0.08 mg/kg or 0.12 mg/kg oxycodone, anesthesia with 0.10 mg/kg oxycodone can effectively maintain the stability of postoperative pain-causing substances, PI, and intestinal barrier function in patients undergoing gastrointestinal tumor surgery, with good safety.
keywords: Oxycodone Gastrointestinal cancer Pain-causing substance Blood perfusion index Intestinal barrier function
文章编号： 中图分类号：R614.2 文献标志码：A
基金项目:北京医学奖励基金会项目（YXJL-2023-0535-0127）
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