中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
11期
23-25
,共3页
腹腔镜胆总管探查术%利多卡因%镇痛%胃肠功能%影响
腹腔鏡膽總管探查術%利多卡因%鎮痛%胃腸功能%影響
복강경담총관탐사술%리다잡인%진통%위장공능%영향
Laparoscopic common bile duct exploration%Lidocaine%Analgesia%Gastrointestinal function%Impact
目的：评价静注利多卡因对腹腔镜胆总管探查术患者镇痛和胃肠功能的影响。方法：选取2012年3月-2013年4月在本院肝胆外科择期行腹腔镜胆总管探查术的146例患者，按照入院号的奇偶性将其分为利多卡因组和生理盐水组各73例，利多卡因组采用利多卡因静注，生理盐水组采用等量生理盐水。记录两组患者手术时间、七氟醚用量、术后首次排气和排便时间、住院时间和不良反应发生情况，术后不同时点，采用VAS法对患者疼痛情况进行评分，利用高效液相色谱仪对血液标本中利多卡因进行监测。结果：利多卡因组患者术中七氟醚用量明显少于生理盐水组，首次排气时间、排便时间和住院时间均明显短于生理盐水组，差异均有统计学意义（P<0.05）；利多卡因组患者术后2、6、12、24 h时VAS评分均明显低于生理盐水组，差异均有统计学意义（P<0.05）；而48 h和72 h时VAS评分比较差异无统计学意义（P>0.05）。利多卡因组总不良反应发生率4.1%明显低于生理盐水组的19.2%，差异有统计学意义（P<0.05）。结论：合适剂量的利多卡因静注有助于改善腹腔镜胆管探查术患者术后镇痛效果，减少全麻药物用量，促进胃肠功能恢复，减少并发症的发生，利于术后康复。
目的：評價靜註利多卡因對腹腔鏡膽總管探查術患者鎮痛和胃腸功能的影響。方法：選取2012年3月-2013年4月在本院肝膽外科擇期行腹腔鏡膽總管探查術的146例患者，按照入院號的奇偶性將其分為利多卡因組和生理鹽水組各73例，利多卡因組採用利多卡因靜註，生理鹽水組採用等量生理鹽水。記錄兩組患者手術時間、七氟醚用量、術後首次排氣和排便時間、住院時間和不良反應髮生情況，術後不同時點，採用VAS法對患者疼痛情況進行評分，利用高效液相色譜儀對血液標本中利多卡因進行鑑測。結果：利多卡因組患者術中七氟醚用量明顯少于生理鹽水組，首次排氣時間、排便時間和住院時間均明顯短于生理鹽水組，差異均有統計學意義（P<0.05）；利多卡因組患者術後2、6、12、24 h時VAS評分均明顯低于生理鹽水組，差異均有統計學意義（P<0.05）；而48 h和72 h時VAS評分比較差異無統計學意義（P>0.05）。利多卡因組總不良反應髮生率4.1%明顯低于生理鹽水組的19.2%，差異有統計學意義（P<0.05）。結論：閤適劑量的利多卡因靜註有助于改善腹腔鏡膽管探查術患者術後鎮痛效果，減少全痳藥物用量，促進胃腸功能恢複，減少併髮癥的髮生，利于術後康複。
목적：평개정주리다잡인대복강경담총관탐사술환자진통화위장공능적영향。방법：선취2012년3월-2013년4월재본원간담외과택기행복강경담총관탐사술적146례환자，안조입원호적기우성장기분위리다잡인조화생리염수조각73례，리다잡인조채용리다잡인정주，생리염수조채용등량생리염수。기록량조환자수술시간、칠불미용량、술후수차배기화배편시간、주원시간화불량반응발생정황，술후불동시점，채용VAS법대환자동통정황진행평분，이용고효액상색보의대혈액표본중리다잡인진행감측。결과：리다잡인조환자술중칠불미용량명현소우생리염수조，수차배기시간、배편시간화주원시간균명현단우생리염수조，차이균유통계학의의（P<0.05）；리다잡인조환자술후2、6、12、24 h시VAS평분균명현저우생리염수조，차이균유통계학의의（P<0.05）；이48 h화72 h시VAS평분비교차이무통계학의의（P>0.05）。리다잡인조총불량반응발생솔4.1%명현저우생리염수조적19.2%，차이유통계학의의（P<0.05）。결론：합괄제량적리다잡인정주유조우개선복강경담관탐사술환자술후진통효과，감소전마약물용량，촉진위장공능회복，감소병발증적발생，리우술후강복。
Objective:To investigate the impact of intravenous lidocaine on analgesic and gastrointestinal function in patients undergoing laparoscopic common bile duct exploration.Method:146 patients underwent elective laparoscopic common bile duct exploration in the department of hepatobiliary surgery in our hospital were selected from March 2012 to April 2013.All cases were randomly divided into the lidocaine group and the saline group,73 cases in each group.The lidocaine group was given intravenous lidocaine and the saline group was given equivalent normal saline.The operative time,sevoflurane consumption,the first exhaust time and defecation time,hospital stay and adverse events of the two groups were recorded.At the different time points after surgery,the pain scores were evaluated by VAS law.The content of lidocaine of blood samples were monitored by high performance liquid chromatography.Result:The sevoflurane consumption of the lidocaine group was significantly less than the saline group,and the first exhaust time,defecation time and hospital stay were significantly shorter than the saline group,the differences were statistically significant(P<0.05).At 2,6,12,24 h after surgery,VAS scores of patients in lidocaine group were all significantly lower than the saline group,the differences were all statistically significant (P<0.05),but there were no significant difference at 48 h and 72 h VAS score(P>0.05).The total adverse reactions occurring rate in the lidocaine group was 4.1%,it was significantly lower than than 19.2%of the saline group,the difference was statistically significant(P<0.05).Conclusion:Suitable doses of intravenous can improve the effect of postoperative analgesia of patients undergoing laparoscopic bile duct exploration,reduce the amount of anesthesia drugs,promote recovery of gastrointestinal function,reduce the incidence of complications and promote postoperative rehabilitation.
