作者：任丽霞，贾真

单位：海南省肿瘤医院 麻醉科， 海南 海口 570100

Authors: Ren Lixia，Jia Zhen

Unit: Department of Anesthesiology，Hainan Cancer Hospital，Haikou 570100，Hainan，China

摘要：

目的 基于随机行走模型探讨盐酸氢吗啡酮注射液对晚期胃癌(GC)患者疼痛相关激素水平的影响。方法 选择2019年1月至2022年6月于海南省肿瘤医院治疗的晚期GC患者116例。根据随机数字表法分为观察组和对照组，每组58例。采用随机行走模型评价盐酸氢吗啡酮注射液对晚期GC患者T0(诱导前)、T1(插管时)、T2(切皮时)、T3(术毕)、T4(拔管时)、T5(术后24 h)时疼痛指标、应激反应以及炎症反应的影响。对比分析两组患者术后不良反应发生情况。结果 对照组与观察组患者T5时的视觉模拟评分法(VAS)评分、Karnofsky功能状态评分(KPS)、5-羟色胺(5-HT)水平、前列腺素E2(PGE2)水平以及β-内啡肽(β-EP)水平间的差异均有统计学意义(P<0.05)。与对照组相比，观察组患者T3、T5时的肾上腺素(E)、去甲肾上腺素(NE)以及皮质醇(Cor)水平均更低(P<0.05)。与对照组相比，观察组患者T5、T6、T7时的C反应蛋白(CRP)、白细胞介素-6(IL-6)以及肿瘤坏死因子(TNF)水平均更低(P<0.05)。随机行走模型评价结果显示，观察组患者术后疼痛指标、应激反应以及炎症反应的改善情况均优于对照组。与对照组相比，观察组患者术后不良反应的发生风险更低(P<0.05)。结论 盐酸氢吗啡酮注射液对晚期GC患者术后疼痛指标、应激反应以及炎症反应的改善更优，且患者术后不良反应的发生风险更低。 

关键词：盐酸氢吗啡酮； 晚期胃癌； 疼痛相关激素； 随机行走模型

Abstract：

Objective To investigate the effect of hydromorphone hydrochloride injection on pain-related hormone levels in patients with advanced gastric cancer （GC） based on random walk model. Method Patients with advanced GC （116 cases） treated in our hospital from January 2019 to June 2022 were selected as the research subjects. According to the random number table method ，they were divided into observation group and control group，with 58 cases in each group. The random walk model was used to evaluate the effect of hydromorphone hydrochloride injection on pain indicators ，stress response and inflammatory response in patients with advanced GC. The incidence of postoperative adverse reactions in the two groups was compared and analyzed. Result Compared with the control group，the pain visual analogue scale （VAS） score，Karnofsky performance score （KPS），5 -hydroxytryptamine （5 -HT） level，prostaglandin E2 （PGE2） level and β-endorphin（β-EP） level in the observation group were significantly different at T5（P<0.05）. Compared with the control group，the levels of epinephrine （E），norepinephrine （NE） and cortisol （Cor） at T3 and T5 in the observation group were lower （P<0.05）. Compared with the control group，the levels of C-reactive protein （CRP），interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in the observation group were lower at T5，T6 and T7（P<0.05）. The results of random walking model evaluation showed that the improvement of postoperative pain indicators，stress response and inflammatory response in the observation group were better than those in the control group. Compared with the control group ，the incidence of postoperative adverse reactions in the observation group was lower （P<0.05）. Conclusion Hydromorphone hydrochloride injection improves postoperative pain indicators，stress response and inflammatory response in advanced GC patients better，and the incidence of postoperative adverse reactions is lower.

Key Words: Hydromorphone hydrochloride; Advanced gastric cancer; Pain-related hormones; Random walk model