硬膜外自控镇痛对阑尾炎切除术后患者胃肠激素分泌的影响

Influence of patient controlled epidural analgesia (PCEA)after appendectomy on gastroenteral hormones

关键词:  布比卡因  罗哌卡因  胃动素  胃泌素

Key words:  bupivacaine  ropivacaine  motilin  gastrin

摘要:

［目的］观察急性阑尾炎患者术后硬膜外病人自控镇痛(PCEA)对患者胃动素、胃泌素水平及对胃肠道运动功能的影响。［方法］将急性阑尾炎术后的病人随机分为3组，每组30例，A组术后不镇痛；B组用0.125%的布比卡因、C组用0.125%的罗哌卡因行PCEA,放免法检测3组病人术前和术后胃动素和胃泌素的值。［结果］ A、B、C 3组术前，胃动素值分别为（274.65±4.38）、(253.03±4.30)和（248.64±3.12）pg/mL；胃泌素值分别为 (128.37±5.42)、（140.12±5.60）和（138.32±4.46）pg/mL，3组之间差异无显著性意义（P>0.05）。A、B、C 3组在术后6 h，胃动素值分别为（201.32±2.84）、（285.63±4.46）和（288.72±3.34）pg/mL；胃泌素值分别为（100.72±3.12）、（168.35±6.32）和（160.54±3.12）pg/mL，B、C 2组两种激素水平均明显高于A组（P<0.05）。［结论］术后应用布比卡因和罗哌卡因行PCEA，均可以促进胃动素和胃泌素的分泌，进而促进胃肠功能的恢复。

Abstract:

［Objective］To observe the influence of PCEA (Patient controlled epidural analgesia) after appendectomy on the gastroenteral hormones, motilin and gastrin.［Methods］Ninety patients were divided randomly into three groups, Group A, the patients without PCEA after appendectomy; Group B, the patients with PCEA using 0.125% bupivacaine; Group C, the patients with PCEA using 0.125%ropivacaine. The levels of motilin and gastrin were detected before and after operations.［Results］Before the appendectomy ,the levels of motilin in group A,B and C were （274.65±4.38）,(253.03±4.30)and （248.64±3.12）pg/mL respectively. The levels of gastrin in group A, B and C were (128.37±5.42),（140.12±5.60）and（138.32±4.46）pg/mL respectively . The differences among three groups were not significant（P>0.05）. At 6h after the operation , the levels of motilin in group A, B and C were（201.32±2.84）,（285.63±4.46）and（288.72±3.34）pg/mL respectively; the levels of gastrin in group A, B and C were（100.72±3.12）,（168.35±6.32）and（160.54±3.12）pg/mL respectively. The levels of motilin and gastrin in group B and C were higher than those of group A.(P<0.05).［Conclusions］PCEA with bupivacaine or ropivacaine can stimulate the secretion of motilin and gastrin of patients post appendectomy and promote the recovery of gastroenteral function.