CAJ | 학술논문

目的：探讨氟比洛芬酯超前镇痛对腹腔镜下子宫切除术全麻患者拔管期应激反应和耐管的影响。方法：110例腹腔镜下子宫切除术患者，随机分成对照组和观察组各55例，两组患者均采用异丙酚、瑞芬太尼静复合全麻。对照组：手术前无超前镇痛，观察组：在手术前给予患者氟比洛芬酯超前镇痛。结果：在拔管时，观察组患者 HR、MAP 低于对照组患者 HR、MAP，差异具有统计学意义（P ＜0.01）；在手术结束和拔管时，两组患者的血糖和皮质醇均高于用药前，差异具有统计学意义（P ＜0.01）；观察组患者血糖和皮质醇浓度低于对照组患者血糖和皮质醇浓度，差异具有统计学意义（P ＜0.01）；观察组患者的耐管评分和拔管后疼痛 VAS 评分低于对照组患者耐管评分和拔管后疼痛 VAS 评分，差异具有统计学意义（P ＜0.01）。结论：在腹腔镜下子宫切除术全麻患者中采用氟比洛芬酯超前镇痛能有效的降低患者的心率、平均动脉压、血糖和皮质醇浓度，减少患者拔管后疼痛，提高患者预后。
목적：탐토불비락분지초전진통대복강경하자궁절제술전마환자발관기응격반응화내관적영향。방법：110례복강경하자궁절제술환자，수궤분성대조조화관찰조각55례，량조환자균채용이병분、서분태니정복합전마。대조조：수술전무초전진통，관찰조：재수술전급여환자불비락분지초전진통。결과：재발관시，관찰조환자 HR、MAP 저우대조조환자 HR、MAP，차이구유통계학의의（P ＜0.01）；재수술결속화발관시，량조환자적혈당화피질순균고우용약전，차이구유통계학의의（P ＜0.01）；관찰조환자혈당화피질순농도저우대조조환자혈당화피질순농도，차이구유통계학의의（P ＜0.01）；관찰조환자적내관평분화발관후동통 VAS 평분저우대조조환자내관평분화발관후동통 VAS 평분，차이구유통계학의의（P ＜0.01）。결론：재복강경하자궁절제술전마환자중채용불비락분지초전진통능유효적강저환자적심솔、평균동맥압、혈당화피질순농도，감소환자발관후동통，제고환자예후。
Objectives:To investigate the effect of preemptive analgesia with flurbiprofen axetil in the extu-bation response and endurance of tubes in general anesthesia patients who had hysterectomy laparoscopic.Methods:110 laparoscopic hysterectomy patients were randomly divided into the control group and the observation group,each group of 55 cases.Both two groups were treated with propofol and remifentanil anesthesia.Control group:no pre-emptive analgesia was given before surgery.Observation group:flurbiprofen acetil preemptive analgesia was given before surgery.Results:During extubation,HR and MAP of patients in the observation group were lower than pa-tients in the control group,with statistically significant difference (P <0.01).At the end of surgery and extuba-tion,the patient's blood glucose and cortisol in both groups were lower after treatment,with statistically significant difference (P <0.01).The blood glucose and cortisol concentrations of the patients in the observation group were lower than patients in the control group,with statistically significant difference (P <0.01).The endurance of tube scores and pain VAS scores after extubation in the observation group were lower than the control group,with statisti-cally significant difference (P <0.01).Conclusion:During the laparoscopic hysterectomy,the anesthesia patients using flurbiprofen axetil preemptive analgesia can effectively reduce the patient's heart rate,average arterial pres-sure,blood glucose and cortisol concentrations,reduce pain after extubation and improve the prognosis of patients.