CAJ | 학술논문

目的：观察帕瑞昔布钠在老年胃癌根治术围术期超前镇痛中临床应用的效果。方法选择 ASAⅠ-Ⅱ级,年龄60~75岁,体重>50kg,拟行胃癌根治术的患者40例,随机分为超前镇痛组(P 组,n =20)和对照组(C 组,n =20)。前者采用帕瑞昔布钠进行围术期超前镇痛,后者采用舒芬太尼患者自控镇痛。观察两组患者手术后48h 内平静、咳嗽及体动时的 VAS 评分,记录两组患者术后肠鸣音恢复时间、肛门排气时间及胃管保留时间,并观察记录两组患者相关不良反应。结果 P 组患者在术后24及48h 平静、咳嗽及体动时 VAS 评分均显著低于 C 组患者(P <0.05),P 组患者术后肠鸣音恢复时间和肛门排气时间显著短于 C 组患者(P <0.05),P 组患者恶心及呕吐的发生率明显低于 C 组患者(P <0.05)。结论帕瑞昔布钠可安全用于老年胃癌根治术围术期超前镇痛,镇痛效果确切,并利于患者胃肠功能恢复。
목적：관찰파서석포납재노년위암근치술위술기초전진통중림상응용적효과。방법선택 ASAⅠ-Ⅱ급,년령60~75세,체중>50kg,의행위암근치술적환자40례,수궤분위초전진통조(P 조,n =20)화대조조(C 조,n =20)。전자채용파서석포납진행위술기초전진통,후자채용서분태니환자자공진통。관찰량조환자수술후48h 내평정、해수급체동시적 VAS 평분,기록량조환자술후장명음회복시간、항문배기시간급위관보류시간,병관찰기록량조환자상관불량반응。결과 P 조환자재술후24급48h 평정、해수급체동시 VAS 평분균현저저우 C 조환자(P <0.05),P 조환자술후장명음회복시간화항문배기시간현저단우 C 조환자(P <0.05),P 조환자악심급구토적발생솔명현저우 C 조환자(P <0.05)。결론파서석포납가안전용우노년위암근치술위술기초전진통,진통효과학절,병리우환자위장공능회복。
Objective To observe the clinical effect of parecoxib on perioperative preemptive analgesia in the elderly un-dergoing radical gastrectomy. Methods Forty ASA Ⅰ ~ Ⅱ grade patients undergoing radical gastrectomy, aged 60 ~ 75 years, body weight more than 50kg, were randomly divided into preemptive analgesia group (Group P, n = 20) and control group (Group C, n = 20). The patients in group P received preemptive analgesia with parecoxib. The patients in group C received patient-con-trolled analgesia with sufentanil. The VAS scores of rest, cough and movement were evaluated during 48 hours. The intestinal sounds recovery time, the anal exsufflation time and gastric tube indwelling time were recorded. The side-effect during analgesia period were observed. Results The VAS scores of rest, cough and movement in group P were significantly lower than that in group C (P < 0. 05). The intestinal sounds recovery time and the anal exsufflation time in group P were significantly less than that in group C (P < 0. 05). The incidence of nausea and vomiting in group P were lower than that in group C (P < 0. 05). Conclu-sion The perioperative preemptive analgesia with parecoxib can provide more effective analgesia for the elderly undergoing radical gastrectomy than routine postoperative analgesia.