CAJ | 학술논문

目的评价氟比洛芬酯复合舒芬太尼用于卵巢癌根治术患者静脉自控镇痛(PCIA)的安全性和有效性。方法60例择期行卵巢癌根治术的患者，根据术后PCIA用药方法的不同，分为3组，20例/组:S组:舒芬太尼150 μg;F组:氟比洛芬酯200 mg;FS组:氟比洛芬酯100 mg+舒芬太尼100μg;每组均加入阿扎司琼10 mg，用0.9％氯化钠稀释至100 ml行PCIA。采用疼痛视觉模拟评分(VAS评分)和Ramesay镇静评分评估患者术后48 h内的疼痛和镇静程度，同时记录不良反应。结果3组镇痛效果良好，F组患者术后2h的疼痛VAS评分(3.3±0.8)高于S组(2.6±1.0)和FS组(2.8±1.1)(P＜0.05)。S组患者术后2和4h的Ramesay镇静评分(3.8±0.9，3.6±0.5)高于F组(2.4±0.8，2.3±0.6)和FS组(2.9±0.8，2.6±0.4)(P＜0.05)，术后8h及以后时点差异无统计学意义(P＞0.05)。观察期间S组恶心、呕吐、嗜睡不良反应发生率(20％，15％，20％)高于F(5％，0，5％)和FS组(5％，5％，5％)(P＜0.05)。镇痛期间的患者的腹腔引流量差异无统计学意义(P＞0.05)。3组病人镇痛期间均未发生呼吸抑制、异常出血等并发症。结论氟比洛芬酯复合舒芬太尼PCIA可安全有效用于卵巢癌根治术后疼痛治疗，可显著减少阿片类药物的用量和降低不良反应的发生率。
목적 평개불비락분지복합서분태니용우란소암근치술환자정맥자공진통(PCIA)적안전성화유효성。방법60례택기행란소암근치술적환자，근거술후PCIA용약방법적불동，분위3조，20례/조:S조:서분태니150 μg;F조:불비락분지200 mg;FS조:불비락분지100 mg+서분태니100μg;매조균가입아찰사경10 mg，용0.9％록화납희석지100 ml행PCIA。채용동통시각모의평분(VAS평분)화Ramesay진정평분평고환자술후48 h내적동통화진정정도，동시기록불량반응。결과3조진통효과량호，F조환자술후2h적동통VAS평분(3.3±0.8)고우S조(2.6±1.0)화FS조(2.8±1.1)(P＜0.05)。S조환자술후2화4h적Ramesay진정평분(3.8±0.9，3.6±0.5)고우F조(2.4±0.8，2.3±0.6)화FS조(2.9±0.8，2.6±0.4)(P＜0.05)，술후8h급이후시점차이무통계학의의(P＞0.05)。관찰기간S조악심、구토、기수불량반응발생솔(20％，15％，20％)고우F(5％，0，5％)화FS조(5％，5％，5％)(P＜0.05)。진통기간적환자적복강인류량차이무통계학의의(P＞0.05)。3조병인진통기간균미발생호흡억제、이상출혈등병발증。결론불비락분지복합서분태니PCIA가안전유효용우란소암근치술후동통치료，가현저감소아편류약물적용량화강저불량반응적발생솔。
Objective To evaluate the efficacy and safety of flurbiprofen axeyil injection combined with sufentanil for postoperative patient undergoing ovarian cancer radical operation.Methods 60 postoperative patients undergoing radical ovarian cancer surgery were randomly divided into three groups with 20 cases in each group, including Sufentanil 150 μg (group S) ,Flurbiprofen Axeyil injection 200 mg (group F) ,Flurbiprofen Axeyil injection 100 mg plus Sufentanil 100 μg (group FS).The drugs in each group were added with Azasetron 10 mg and diluted to 100 ml, then infused by a pump in a rate of 2 ml/h.The visual analogue scale (VAS) and Ramesays scores were used to evaluate the analgesic effect at 0.5,2,4,8,12,24 and 48 h after surgery.The incidence of side effects was recorded.Results All the patients showed good pain relief with PCIA.The VAS of group F(3.3 +0.8) at 2 h after operation was slightly higher than that of group S (2.6 + 1.0) and SF (2.8 + 1.1) (P ＜ 0.05), which became similar 4 h later (P ＞0.05).In groups F (2.4 +0.8,2.3 +0.6) and FS(2.9 +0.8,2.6 ±0.4), the average Ramsay score was slightly lower than that in group S(3.8 +0.9,3.6 +0.5) (P ＜0.05).But the differences were not significant within 8 h after operation (P ＞ 0.05).The accidence rates of nausea, vomiting, itching, somnolence of group S(20％ ,15％ ,20％) were significantly higher than those in group F (5％ ,0,5％)and FS(5％,5％ ,5％) (P ＜0.05).No respiratory depression or abnormal bleeding occurred in three groups during the period of postoperative 48 hour.The amount of hydrothorax had no difference between 3 groups (P ＜0.05).Conclusions Intravenous postoperative analgesia with Flurbiprofen Axeyil injection combined with Sufentanil had a better analgesic effect than Sufentanil or Flurbiprofen Axeyil used alone, and it could significantly reduce the dose requirement of Sufentanil as well as its associated side effects.