实用临床医药杂志
實用臨床醫藥雜誌
실용림상의약잡지
JOURNAL OF JIANGSU CLINICAL MEDICINE
2014年
15期
35-37,41
,共4页
地佐辛%舒芬太尼%老年%胃肠道肿瘤根治术%静脉自控镇痛
地佐辛%舒芬太尼%老年%胃腸道腫瘤根治術%靜脈自控鎮痛
지좌신%서분태니%노년%위장도종류근치술%정맥자공진통
dezocine%sufentanil%elderly%radical resection of gastroenteric tumor%post-operative analgesia
目的：观察地佐辛联合舒芬太尼用于老年胃肠道肿瘤根治术后静脉自控镇痛的镇痛效应及其不良反应。方法选择60例 ASA Ⅰ～Ⅱ级择期行胃肠道肿瘤开腹根治手术的老年患者，随机分为地佐辛复合舒芬太尼组（SD 组）和舒芬太尼组（S 组），每组30例。持续监测血压、心率、呼吸频率、SpO2；记录术后4、8、16、24、48 h 各时点安静和90°翻身运动时的 VAS 评分和镇静 Ramsay 评分；记录患者的镇痛满意度评价以及镇痛期间不良反应的发生情况。结果2组术后各时点安静状态下VAS 评分及 Ramsay 镇静评分差异均无统计学意义（P ＞0．05）；翻身运动时 SD 组各时点 VAS 评分均低于 S 组（P ＜0．05）；SD组恶心、呕吐、头晕和寒战的发生率明显低于 S 组（P ＜0．05）。结论地佐辛复合舒芬太尼用于胃肠道肿瘤根治术后静脉自控镇痛对运动痛的镇痛效果优于单用舒芬太尼，且可降低术后恶心、呕吐等不良反应的发生，值得临床推广使用。
目的：觀察地佐辛聯閤舒芬太尼用于老年胃腸道腫瘤根治術後靜脈自控鎮痛的鎮痛效應及其不良反應。方法選擇60例 ASA Ⅰ～Ⅱ級擇期行胃腸道腫瘤開腹根治手術的老年患者，隨機分為地佐辛複閤舒芬太尼組（SD 組）和舒芬太尼組（S 組），每組30例。持續鑑測血壓、心率、呼吸頻率、SpO2；記錄術後4、8、16、24、48 h 各時點安靜和90°翻身運動時的 VAS 評分和鎮靜 Ramsay 評分；記錄患者的鎮痛滿意度評價以及鎮痛期間不良反應的髮生情況。結果2組術後各時點安靜狀態下VAS 評分及 Ramsay 鎮靜評分差異均無統計學意義（P ＞0．05）；翻身運動時 SD 組各時點 VAS 評分均低于 S 組（P ＜0．05）；SD組噁心、嘔吐、頭暈和寒戰的髮生率明顯低于 S 組（P ＜0．05）。結論地佐辛複閤舒芬太尼用于胃腸道腫瘤根治術後靜脈自控鎮痛對運動痛的鎮痛效果優于單用舒芬太尼，且可降低術後噁心、嘔吐等不良反應的髮生，值得臨床推廣使用。
목적：관찰지좌신연합서분태니용우노년위장도종류근치술후정맥자공진통적진통효응급기불량반응。방법선택60례 ASA Ⅰ～Ⅱ급택기행위장도종류개복근치수술적노년환자，수궤분위지좌신복합서분태니조（SD 조）화서분태니조（S 조），매조30례。지속감측혈압、심솔、호흡빈솔、SpO2；기록술후4、8、16、24、48 h 각시점안정화90°번신운동시적 VAS 평분화진정 Ramsay 평분；기록환자적진통만의도평개이급진통기간불량반응적발생정황。결과2조술후각시점안정상태하VAS 평분급 Ramsay 진정평분차이균무통계학의의（P ＞0．05）；번신운동시 SD 조각시점 VAS 평분균저우 S 조（P ＜0．05）；SD조악심、구토、두훈화한전적발생솔명현저우 S 조（P ＜0．05）。결론지좌신복합서분태니용우위장도종류근치술후정맥자공진통대운동통적진통효과우우단용서분태니，차가강저술후악심、구토등불량반응적발생，치득림상추엄사용。
Objective To explore the effect and side effects of dezocine combined with sufentanil in patient-controlled intravenous analgesia(PCIA)of elderly patients with radical resec-tion of gastroenteric tumor.Methods 60 elderly patients with selective radical operation for gas-troenteric tumor were randomly divided into dezocine combined with sufentanil group (group DS,n=30)and sufentanil group (group S,n =30).Continuous monitoring was used to record blood pressure,heart rate,respiratory rate and SpO2,the VAS scores during both silence and 90°turn over situation were recorded,and Ramsay scores at 4,8,16,24 and 48 hours after operation as well as the adverse reactions were compared.Results There were no significant differences of Ramsay score and VAS pain during silence between two groups,but there was a significant differ-ence of VAS pain under turn-over situation between two groups(P <0.05).In group SD,the in-cidence rates of side effects such as nausea,vomiting,dizziness and shivering were significantly low-er than those in group S(P <0.05).Conclusion Application of dezocine combined with sufentanil has a preferable therapeutic effect for post-operative movement pain and less adverse effects,and it is worthy of clinical application and popularization.
