Résumé
Objective To investigate effects of parecoxib sodium preemptive analgesia on postoperative analgesia and cellu‐lar immune function in patients with uterine fibroids.Methods Totally ,116 cases of patients receiving uterine fibroids surgery were selected from March 2011 to April 2014 in our hospital.All cases were randomly divided into advanced group(n=58)and control group(n=58). The cases in the advanced group were intravenously injected with parecoxib sodium(40 mg)30 min before anesthesia ,while the control group received 5 mL saline intravenously.Postoperative pain conditions of the two groups were e‐valuated by using visual analog scale(VAS method). The PCIA pump first trigger time ,effective compression number and the total amount of fentanyl were recorded. Venous blood was collected before operation ,6 h(T1 ) ,24 h(T2 ) ,48 h(T3 )and 72 h(T4 ) after operation ,respectively. T lymphocyte subsets of CD3+ ,CD4+ and CD8+ and NK cells were detected by using FACS Cali‐bur flow cytometer.The ratio of CD4+ /CD8+ was calculated.Results After 4 ,8 ,12 ,24 and 48 h ,the pain scores of patients were significantly lower in the advanced group than in the control group(all P<0.05). The PCIA pump first trigger time was longer ,effective compression number and the total amount of fentanyl of patients were less in the advanced group than in the control group ,the differences were statistically significant(all P<0.05). At T1 ,T2 and T3 ,CD3+ and CD4+ were significantly higher in the advanced group than in the control group(P<0.05).At T1 and T2 ,CD4+ /CD8+ was significantly higher in the advanced group than in the control group(both P<0.05).At T2 and T3 ,the NK was significantly higher in the advanced group than in the control group(both P<0.05).Conclusion Parecoxib sodium preemptive analgesia used in patients with uterine fi‐broids can reduce postoperative pain ,reduce the amount of analgesics ,reduce the immune suppression ,and improve immune function in patients after surgery.
Résumé
Objective To evaluate the role of curved-cutter-stapler in anus-preserving for low rectal cancer.Methods The clinical data of 32 patients with low rectal cancer from June 2007 to December 2008 who received low anterior resection and ultra low anterior resection by using curved-cutter-stapler were reviewed retrospectively.Results No operation death case,complete cutting and safe closure in all cases,one case was complicated with anastomotic leakage,and one case of rectovaginal fistula.Thirty patients were followed up 4 to 22 months after the operation,with an average time of 12.6 months,no hemorrhea of pelvic cavity and anastomotic stoma or anastomotic stenosis cases.Conclusion Curved-cutter-stapler has the advantages of complete cutting,safe closure and low complications,and easy being used in anus-preserving operation for low rectal cancer,which can increase the rate of anus-preserving.