CAJ | 학술논문

目的：探讨舒芬太尼联合帕瑞昔布钠在老年食管癌患者术后静脉镇痛中的安全性及有效性。方法随机选取择期行食管癌根治术老年患者60例，分为联合组和单药组各30例，两组均采用舒芬太尼自控镇痛，联合组在麻醉诱导时和诱导后12 h分别静脉注射帕瑞昔布钠40 mg，单药组不予帕瑞昔布钠。记录并比较两组术后6、24、48 h活动时的VAS评分、Ramsay镇静评分，舒芬太尼的用量及生命体征指标和不良反应的发生率。结果联合组各时间点的 VAS 评分低于单药组， Ramsay镇静评分高于单药组（P＜0.05），舒芬太尼的用量亦少于单药组（P＜0.05）。两组不良反应的发生率比较差异无统计学意义（P＞0.05）。结论舒芬太尼联合帕瑞昔布用于老年食管癌患者术后镇痛的效果优于单用舒芬太尼，同时能安全有效地减少术后镇痛泵中舒芬太尼的用量。
목적：탐토서분태니연합파서석포납재노년식관암환자술후정맥진통중적안전성급유효성。방법수궤선취택기행식관암근치술노년환자60례，분위연합조화단약조각30례，량조균채용서분태니자공진통，연합조재마취유도시화유도후12 h분별정맥주사파서석포납40 mg，단약조불여파서석포납。기록병비교량조술후6、24、48 h활동시적VAS평분、Ramsay진정평분，서분태니적용량급생명체정지표화불량반응적발생솔。결과연합조각시간점적 VAS 평분저우단약조， Ramsay진정평분고우단약조（P＜0.05），서분태니적용량역소우단약조（P＜0.05）。량조불량반응적발생솔비교차이무통계학의의（P＞0.05）。결론서분태니연합파서석포용우노년식관암환자술후진통적효과우우단용서분태니，동시능안전유효지감소술후진통빙중서분태니적용량。
Objective To explore the effectiveness and safety of sufentanil combined with parecoxib postoperative analgesia applied in elderly patients with esophageal carcinoma. Methods Sixty elderly patients with esophageal carcinoma were randomly divided into combination group (n=30)and single-agent group (n=30). Both groups received patient-controlled intravenous analgesia of sufentanil,combination group received intravenous injection of 40 mg parecoxib sodium during induction of anesthesia and 1 2 h after induction,single-drug group didn't use parecoxib sodium. Activity VAS scores,Ramsay sedation scores,dosage of sufentanil, vital signs and the incidence of adverse reactions 6 h,24 h,48 h after surgery were recorded and compared.Results Activity VAS score and dosage of sufentanil of combination group at every time point were significant-ly lower than those of sing-drug group,while Ramsay sedation scores were higher (P<0.05 ). There was no statistically significant difference between two groups in the incidence of adverse reactions (P>0.05 ). Con-clusion Sufentanil combined with parecoxib is more effective than using sufentanil alone in elderly patients with esophageal carcinoma,furthermore,dosage of sufentanil can be reduced safely and effectively.