CAJ | 학술논문

目的：探讨帕瑞昔布钠超前镇痛对无神经损伤性胸腰椎骨折术后镇痛及谵妄的影响，促进患者术后康复。方法选择符合标准的患者80例，随机分为观察组和对照组各40例，观察组超前镇痛应用帕瑞昔布钠，对照组应用舒芬太尼，观察镇痛效果及谵妄发生率。结果2组患者手术时间及术中出血量比较，差异无统计学意义。术后2 h、6 h、12 h、24 h及48 h观察组患者疼痛视觉模拟评分法VAS评分及静脉自控镇痛泵累计按压次数均明显低于对照组，差异有统计学意义（P＜0.05）。观察组患者首次按压静脉自控镇痛泵时间为术后（3.84±0.62）h，明显晚于对照组的（1.05±0.47） h,差异有统计学意义（P＜0.05）。观察组患者术后7 d之内谵妄发生率为10.00%，明显低于对照组的25.00%（P＜0.05）。结论无神经损伤性胸腰椎骨折手术应用帕瑞昔布钠行超前镇痛，可以提高患者术后镇痛效果，降低术后谵妄的发生率，安全性高，值得临床应用。
목적：탐토파서석포납초전진통대무신경손상성흉요추골절술후진통급섬망적영향，촉진환자술후강복。방법선택부합표준적환자80례，수궤분위관찰조화대조조각40례，관찰조초전진통응용파서석포납，대조조응용서분태니，관찰진통효과급섬망발생솔。결과2조환자수술시간급술중출혈량비교，차이무통계학의의。술후2 h、6 h、12 h、24 h급48 h관찰조환자동통시각모의평분법VAS평분급정맥자공진통빙루계안압차수균명현저우대조조，차이유통계학의의（P＜0.05）。관찰조환자수차안압정맥자공진통빙시간위술후（3.84±0.62）h，명현만우대조조적（1.05±0.47） h,차이유통계학의의（P＜0.05）。관찰조환자술후7 d지내섬망발생솔위10.00%，명현저우대조조적25.00%（P＜0.05）。결론무신경손상성흉요추골절수술응용파서석포납행초전진통，가이제고환자술후진통효과，강저술후섬망적발생솔，안전성고，치득림상응용。
Objective To investigate the effects of preemptive analgesia with parecoxib sodium on postoperative analgesia and delirium after nerve injury-free surgery for fracture of thoracic and lumbar vertebrae and to promote the postoperative rehabilitation of the patients. Method 80 patients meeting the criteria were selected. and randomly divided into observation group and control group.40 patients each group. The observation group used parecoxib sodium for preemptive analgesia. while the control group used sufentanil. and the analgesia effects and the incidences of delirium were observed. Results The differences in operative time and intra-operative blood loss between the patients of the two groups were statistically insignificant. In 2 h. 6 h. 12 h.24 h and 48 h after the surgery.the VAS score and the accumulative time of intravenous self-controlled analgesia pump being pressed of the observation group were significantly lower than those of the control group. and the differences were statistically significant (P<0.05). The first time for the patients of the observation group to press the intravenous self-controlled analgesia pump is (3.84±0.62) h after the surgery, is significantly later than that of the control group (1.05±0.47)h.and the difference is statistically significant (P<0.05). The incidence of delirium in 7 days after the surgery in the patients of the observation group was 10.00%. and is significantly lower than that of the control group (25.00%) (P<0.05). Conclusion Using parecoxib sodium for preemptive analgesia before nerve injury-free surgery for fracture of thoracic and lumbar vertebrae can elevate the postoperative analgesia effects of the patients.decrease the incidence of postoperative delirium, and is highly safe and consequently worthy of clinical application.