CAJ | 학술논문

[目的]研究帕瑞昔布钠超前镇痛对乳腺癌根治术患者血小板及凝血功能的影响.[方法]选择ASAⅠ-Ⅱ级择期行乳腺癌根治术患者40例,随机分为帕瑞昔布钠组(A组,n=20)和生理盐水组(B组,n=20).A组在麻醉诱导前10 min给予帕瑞昔布钠40mg+生理盐水4ml静脉注射,B组在麻醉诱导前10 min给予生理盐水4ml静脉注射,术后均予喷他佐辛自控镇痛(PCA).分别记录两组患者清醒即刻(T0)、术后2 h(T1)、4 h(T2)、6 h(T3)、8h(T4)、12 h(T5)及24 h(T6) VAS评分和Ramsay镇静评分.两组患者分别在术前和静脉注射试验药物后60min抽取静脉血,测定血小板聚集率、凝血酶原时间(PT)、凝血酶时间(TT)、激活部分凝血酶原时间(APTT)和纤维蛋白原浓度(Fib).[结果]两组病例术后24h内Ramsay镇静评分的差异无统计学意义(P＞0.05),A组VAS评分低于B组,差异有统计学意义(P＜0.05).两组患者术前和给药后60 min血小板聚集功能及凝血功能比较差异无统计学意义.[结论]与单独应用喷他佐辛术后镇痛相比,帕瑞昔布钠超前镇痛用于乳腺癌根治术患者的效果更确切且不影响患者的血小板和凝血功能.
[목적]연구파서석포납초전진통대유선암근치술환자혈소판급응혈공능적영향.[방법]선택ASAⅠ-Ⅱ급택기행유선암근치술환자40례,수궤분위파서석포납조(A조,n=20)화생리염수조(B조,n=20).A조재마취유도전10 min급여파서석포납40mg+생리염수4ml정맥주사,B조재마취유도전10 min급여생리염수4ml정맥주사,술후균여분타좌신자공진통(PCA).분별기록량조환자청성즉각(T0)、술후2 h(T1)、4 h(T2)、6 h(T3)、8h(T4)、12 h(T5)급24 h(T6) VAS평분화Ramsay진정평분.량조환자분별재술전화정맥주사시험약물후60min추취정맥혈,측정혈소판취집솔、응혈매원시간(PT)、응혈매시간(TT)、격활부분응혈매원시간(APTT)화섬유단백원농도(Fib).[결과]량조병례술후24h내Ramsay진정평분적차이무통계학의의(P＞0.05),A조VAS평분저우B조,차이유통계학의의(P＜0.05).량조환자술전화급약후60 min혈소판취집공능급응혈공능비교차이무통계학의의.[결론]여단독응용분타좌신술후진통상비,파서석포납초전진통용우유선암근치술환자적효과경학절차불영향환자적혈소판화응혈공능.
[Objective]To investigate the effect of preemptive parecoxib on platelet function and blood coagulation in patients of radical excision of breast cancer.[Methods] Forty ASA Ⅰ - Ⅱ patients were randomized to one of 2 groups( n=20 each):parecoxib group( group A) received intravenous parecoxib 40 mg/4 ml at 10 min before anesthesia and control group( group B) received normal saline 4 ml instead of parecoxib.Both patients received patient-controlled analgesia(PCA)with pentazocine after surgery.VAS scores and Ramsay scores were recorded at 0 h,2 h,4 h,6 h,8 h,12 h,24 h(T0-6) after surgery.Venous blood samples were taken at 1 h after parecoxib or normal saline administration for platelet function and blood coagulation function.[Results] Compared with group B VAS scores at T0-6 were all decreased in group A(P ＜0.05).There were no significant difference in Ramsay score,platelet function and blood coagulation function between the 2 groups ( P ＞ 0.05 ).Conclnsions Preemptive parecoxib can effectively relieve postoperative pain and have not significant effects on platelet function and blood coagulation function in patients of radical excision of breast cancer.