| Objective To apply flurbiprofen ester combined with penehyclidine hydrochloride to patients undergoing laparoscopic cholecystectomy.To observe whether the combination of the two can further reduce the level of inflammatory factors to achieve the effect of postoperative pulmonary protection.Methods Eighty patients who underwent elective laparoscopic cholecystectomy in baotou central hospital from December 2018 to December 2019 were selected.The preoperative blood,gas and lung functions were all normal.The anesthesia method was general anesthesia under endotracheal intubation.The patients were randomly divided into 4 groups with 20 cases in each group.Group A: patients were given0.015mg/kg penehyclidine hydrochloride intravenously 3min before surgery;group B:patients were given 1mg/kg flurbiprofen ester intravenously 3min before surgery;group C: conditions were compounded in group AB;group D: no special treatment was given under conventional anesthesia.BP,ECG,Sp O2,Pet CO2,BIS and NMT values were routinely monitored with a multifunctional monitor.Vt,Pax,Plateau and PEEP were monitored by anaesthesia machine,and 3 m L of venous blood was taken5min(T1)before surgery,25min(T2)after pneumoperitoneum,and 30min(T3)after pneumoperitoneum venting respectively,to measure the concentration of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6),And 2 ml arterial blood was extracted at the above time point and the p H value of blood gas index Pa O 2 Pa CO 2was determined by blood gas analyzerResults(1)pH value:The interaction between the four groups at three time points and between groups and time was statistically significant(P < 0.05),and the difference between groups was statistically significant(F=17.454,P=0.000).There was no difference in p H value between the four groups at T1 time point(P >0.05).The p H values of group A and C in the experimental group at T2 time point were significantly higher than those of the blank group of group D,while those of group B and group D at T3 time point were lower than those of group A and group C(P < 0.05).The trend of time change in the group was statistically significant(F=60.775,P=0.000).The p H value of the experimental group A,B and C declined first and then rose,while that of the blank group D declined.(2)Pa CO2: All the four groups,three time points and the interaction between groups and time were statistically significant(P < 0.05),and the differences between groups were statistically significant(F=15.109,P=0.000).Moreover,the differences between groups at T1 time point 4 were not statistically significant(P > 0.05).At time points T2 and T3,group B and group D were significantly higher than group A and group C(P < 0.05).The trend of time change in the group was statistically significant(F=46.733,P=0.000).The overall trend of the four groups increased significantly at first and then decreased slowly,and the trend of the blank group D increased significantly.(3)Pa O2: there was no statistically significant difference between groups(F=0.101,P=0.959).The trend of time change was statistically significant(F=22.346,P=0.000),and the overall trend of all four groups decreased significantly first and then increased.(4)TNF-?: The interaction between the four groups,the three time points and the time was statistically significant(P < 0.05).There were statistically significant differences between the groups(F=19.325,P=0.000),and no statistically significant differences between the four groups at time point T1(P >0.05).At time points T2 and T3,group D was significantly higher than group A,group B and group C,and group C was lower than group A and group B(P < 0.05).The trend of time change in the four groups was statistically significant(F=52.944,P=0.000).(5)IL-6: the difference between groups was statistically significant(F=7.842,P=0.000),and there was no statistically significant difference in il-6 concentration between groups at time T1(P > 0.05).At time T2,group D was significantly higher than group A and group B was significantly higher than group C.At time T3,group D was significantly higher than group B and group C,and at time T2 and group C were the lowest(P < 0.05).The trend of time change was statistically significant(F=38.356,P=0.000),and the overall trend of the four groups showed a significant upward trend followed by a slow downward trend.Conclusion: The application of flurbiprofen ester combined with penehyclidine hydrochloride in laparoscopic surgery can significantly inhibit the expression of inflammatory mediators,reduce the lung damage caused by pneumoperitoneum and mechanical ventilation during surgery,and contribute to the recovery of lung function after surgery.the effect is better than the use of a single drug. |
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