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目的：观察不同剂量的地佐辛与芬太尼配伍对腰椎手术后患者自控静脉镇痛应激反应的影响。方法选择医院2013年1月-2015年1月行腰椎手术患者100例，随机分为5组各20例。根据镇痛药物用量不同分为：芬太尼（ F）组为芬太尼18μg/Kg，配伍1（ DF1）组为地佐辛0.3mg/Kg Q芬太尼12μg/Kg，配伍2（ DF2）组为地佐辛0.45mg/Kg Q芬太尼9μg/Kg，配伍3（DF3）组为地佐辛0.6mg/Kg Q芬太尼6μg/Kg，地佐辛（D）组为地佐辛0.9mg/Kg，每组泵中均加入昂丹司琼8mg和0.9%氯化钠溶液共配制成100ml，各组背景输注速率2ml/h。于术后2h、6h、12h、24h及48h采用视觉模拟评分法（ VAS评分）评价镇痛效果，并于入手术室后10min及术后2h、6h、24h采集静脉血测定血糖（ Glu）及血浆皮质醇（ Cor）、肾上腺素（ E）和去甲肾上腺素（ NE）的浓度。结果与F、D组比较，DF1、DF2、DF3组术后2h、6h、12h及24h VAS评分和术后2h、6h及24h Glu、血浆Cor、E、NE浓度均降低（ P<0.05或0.01）；与DF1和DF3组比较，DF2组术后2h、6h、12h及24h VAS评分和术后2h、6h和24h Glu、血浆Cor、E、NE浓度降低（ P<0.05）。结论地佐辛与芬太尼不同剂量配伍 PCIA镇痛效果及减轻术后应激反应作用均优于二者单独应用，且以配伍2（ DF2）组应激反应最低。“,”Objective To study the effects of different doses of dezocine matching with fentanyl on the stress reaction of patients who self-control intravenous analgesia in with lumbar spine surgery. Methods From January 2013-January 2015, 100 cases of patients with lumbar spine surgery,were randomly divided into 5 groups,20 cases in each group. According to dif-ferent dosage of analgesic drugs are divided into:fentanyl( F)for a group of fentanyl 18 mu g/Kg,compatibility of group 1 (DF1)istoassistsymplectic0.3mg/KgQ12μg/Kg,fentanylcompatibilitygroup2(DF2)istoassistsymplectic0.45mg/Kg plus fentanyl 9μg/Kg,compatibility group 3( DF3 )is to assist symplectic 0. 6mg/Kg plus fentanyl 6μg/Kg,to assist sheen ( group D)is to assist symplectic 0. 9mg/Kg,pump in each group were to join the Dan SiQiong 8 mg and normal saline mixture 100ml,groups of bacKground infusion rate of 2 ml/h. At postoperative 2h,6h,12h,24h and 48h by using visual analogue scale (VAS score)to evaluate analgesic effect,and on into the operating room after 10min and 2h,6h,24h after venous blood was collected to determine blood glucose( Glu)and plasma cortisol( Cor),epinephrine( E)and norepinephrine( NE)concentra-tion. Results compared with group D,F,and DF1 ,DF2 ,DF3 group after 2h,6h,12h and 24h VAS score and 2h,6h and 24h after Glu,concentration of plasma Cor,E and NE were lower(P<0. 05 or 0. 01);Compared with DF1 and DF3 group,postoper-ative DF2 group 2h,6h,12h and 24h VAS score and 2h,6h and 24h after Glu,concentration of plasma Cor,E,NE lower(P<0. 05). Conclusion with sheen and compatibility of different doses of fentanyl PCIA analgesia effect and reduce the postoper-ative stress reaction were superior to the two separate applications,compatibility and in group 2( DF2 )lowest stress reaction.