CAJ | 학술논문

目的：比较凯纷与曲马多单次静脉给药对于脊柱侧弯患者术后早期镇痛的临床效果及不良反应。方法将该院2011年9月至2013年2月收治的进行脊柱侧弯术的92例患者作为研究对象，完全随机分为凯纷组、曲马多组，每组各46例，两组均采用气管插管静脉全身麻醉。手术结束前10 min ，凯纷组患者静脉注射凯纷1 mg／kg ，曲马多组患者静脉注射曲马多1 mg／kg。观察并记录两组术前（T0），给药时（T1），拔管时（T2），拔管后5 min （T3），拔管后10 min（T4），拔管后30 min（T5）及拔管后1 h（T6）患者的生命体征，以及 T3～T6的疼痛评分，观察用药后患者的不良反应。结果凯纷组T3～T6的疼痛评分均低于同时段曲马多组，且 T3、T4、T5时间点时凯纷组疼痛评分明显低于曲马多组，差异有统计学意义（P＜0．05），T6时差异无统计学意义（P＞0．05）；凯纷组有3例患者发生不良反应，占6．52％，远低于曲马多组的11例（23．91％），差异有统计学意义（ P＜0．05）；凯纷组恶心呕吐评分为（0．39 ± 0．21）分，明显低于曲马多组的（1．17 ± 0．14）分，二者差异有统计学意义（P＜0．01）；T2及T3时凯纷组心率的变化小于曲马多组，差异有统计学意义（P＜0．05），其他时间点差异无统计学意义（P＞0．05）；血压及血氧饱和度各时间点的差异无统计学意义（P＞0．05）。结论脊柱侧弯患者术后早期镇痛中凯纷的效果优于曲马多，且生命体征更为稳定，不良反应少，具有一定的临床价值。
목적：비교개분여곡마다단차정맥급약대우척주측만환자술후조기진통적림상효과급불량반응。방법장해원2011년9월지2013년2월수치적진행척주측만술적92례환자작위연구대상，완전수궤분위개분조、곡마다조，매조각46례，량조균채용기관삽관정맥전신마취。수술결속전10 min ，개분조환자정맥주사개분1 mg／kg ，곡마다조환자정맥주사곡마다1 mg／kg。관찰병기록량조술전（T0），급약시（T1），발관시（T2），발관후5 min （T3），발관후10 min（T4），발관후30 min（T5）급발관후1 h（T6）환자적생명체정，이급 T3～T6적동통평분，관찰용약후환자적불량반응。결과개분조T3～T6적동통평분균저우동시단곡마다조，차 T3、T4、T5시간점시개분조동통평분명현저우곡마다조，차이유통계학의의（P＜0．05），T6시차이무통계학의의（P＞0．05）；개분조유3례환자발생불량반응，점6．52％，원저우곡마다조적11례（23．91％），차이유통계학의의（ P＜0．05）；개분조악심구토평분위（0．39 ± 0．21）분，명현저우곡마다조적（1．17 ± 0．14）분，이자차이유통계학의의（P＜0．01）；T2급T3시개분조심솔적변화소우곡마다조，차이유통계학의의（P＜0．05），기타시간점차이무통계학의의（P＞0．05）；혈압급혈양포화도각시간점적차이무통계학의의（P＞0．05）。결론척주측만환자술후조기진통중개분적효과우우곡마다，차생명체정경위은정，불량반응소，구유일정적림상개치。
Objective To compare the effect of offlurbiprofen acetate injection and tramadol for early postoper‐ative analgesia and side effects after scoliosis surgery .Methods A total of 92 patients treated with scoliosis surgery from September 2011 to February 2013 were selected as subjects in this study ,divided into flurbiprofen acetate injec‐tion group and tramadol group randomly ,46 patients in each group .All the patients were all treated with intravenouos anesthesia endotracheal intubation .The flurbiprofen acetate injection group were injected flurbiprofen acetate (1 mg/kg) and the tramdo group were injected tramdo (2 mg/kg) 10 min before the end of operation .The analgesic efficacy and side effects were observed and recorded before operation (T0) ,after administration(T1) ,when the tube drawing (T2) ,after extubation 5(T3) ,10(T4) ,30(T5) ,60(T6) min after extubation .Results The pain scores at T3 ,T4 ,T5 in flurbiprofen acetate injection group were lower than those at the same segment in tramado group (P<0 .05) ,but no significant different found at T6(P>0 .05) .There were three patients (6 .52% ) with side effects in flurbiprofen ace‐tate injection group ,the incidence rate was significant lower than tramado group (23 .91% )(P<0 .05) .The nausea and vomiting score in flurbiprofen acetate injection group (0 .39 ± 0 .21) was significant lower than that of tramadol group (1 .17 ± 0 .14) ,the difference was significant (P<0 .05) .The heart rates at T2 and T3 in flurbiprofen acetate injection group were less than those of tramadol group ,the difference was significant (P<0 .05) ,there were no sig‐nificant differences on other time points (P> 0 .05) .There were no significant differences on blood pressure and blood oxygen saturation on different time points (P>0 .05) .Conclusion Analgesia effect of flurbiprofen acetate in‐jection is significant better than tramadol for scoliosis surgery ,and patients using flurbiprofen acetate injection has more stable vital signs ,less adverse reactions .