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[摘要]
目的 探究普瑞巴林胶囊对腰椎间盘突出微创术患者术后疼痛及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平的影响。方法 选取2014年1月-2018年1月于延安大学附属医院进行微创治疗的138例腰椎间盘突出患者为研究对象,按照随机数字表法将其分为对照组和实验组,每组各69例。对照组患者于麻醉实施2 h前服用塞来昔布胶囊0.4g,术后对照组患者每12 h服用一次塞来昔布胶囊进行镇痛,每次服用剂量为0.2 g;实验组患者麻醉前服用普瑞巴林胶囊200 mg,术后每12 h服用一次普瑞巴林胶囊进行镇痛,服用剂量为150 mg/次。比较两组患者静息痛及活动痛VAS评分、血清炎性因子水平和远期随访3个月内的神经性病理疼痛发生率。结果 术后,两组VAS评分均有所下降,同组治疗前后比较差异具有统计学意义(P<0.05),且实验组患者术后12、24、72 h静息痛及活动痛VAS评分均低于对照组,两组比较差异具有统计学意义(P<0.05)。术后72 h两组TNF-α、IL-6水平均有所下降,同组治疗前后比较差异具有统计学意义(P<0.05);同时实验组血清因子水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。术后3个月随访示实验组神经性病理疼痛发生率低于对照组,两组比较差异有统计学意义(P<0.05)。结论 普瑞巴林胶囊能够有效缓解腰椎间盘突出微创术患者术后疼痛,同时降低其血清TNF-α、IL-6水平,且远期随访效果较好,值得进行临床推广使用。
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[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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