CAJ | 학술논문

目的：评价舒芬太尼对糖尿病周围神经病变术后镇痛效应的影响。方法腹部手术患者,根据密歇根糖尿病神经病变评分法(MDNS),分为4组：非糖尿病组(N 组,n =21)；糖耐量减低组(A 组,n =19)；糖尿病且 MDNS 评分≤2即糖尿病非神经病变组(B 组,n =21)；糖尿病且 MDNS 评分>2即糖尿病合并神经病变组(C 组,n =17)。术毕静注托烷司琼5 mg,并氟哌利多1 mg,连接舒芬太尼静脉镇痛泵。持续镇痛48 h。对术后4、8、24、48 h 进行 VAS 评分,并记录舒芬太尼总用量及不良反应发生率。结果与 N、A 组比较,C 组患者各时间点的 VAS 评分升高,差异有统计学意义；与 B 组比较,C 组在术后24 h 的 VAS 评分差异有统计学意义；与 C 组比较,N、A、B 组48 h 舒芬太尼消耗量降低且差异有统计学意义。结论与非糖尿病及糖尿病非神经病变患者比较,糖尿病神经病变患者对疼痛敏感性增加,舒芬太尼术后镇痛需求量更大。
목적：평개서분태니대당뇨병주위신경병변술후진통효응적영향。방법복부수술환자,근거밀헐근당뇨병신경병변평분법(MDNS),분위4조：비당뇨병조(N 조,n =21)；당내량감저조(A 조,n =19)；당뇨병차 MDNS 평분≤2즉당뇨병비신경병변조(B 조,n =21)；당뇨병차 MDNS 평분>2즉당뇨병합병신경병변조(C 조,n =17)。술필정주탁완사경5 mg,병불고리다1 mg,련접서분태니정맥진통빙。지속진통48 h。대술후4、8、24、48 h 진행 VAS 평분,병기록서분태니총용량급불량반응발생솔。결과여 N、A 조비교,C 조환자각시간점적 VAS 평분승고,차이유통계학의의；여 B 조비교,C 조재술후24 h 적 VAS 평분차이유통계학의의；여 C 조비교,N、A、B 조48 h 서분태니소모량강저차차이유통계학의의。결론여비당뇨병급당뇨병비신경병변환자비교,당뇨병신경병변환자대동통민감성증가,서분태니술후진통수구량경대。
Objective To evaluate the influence of sufentanil on postoperative analgesia in diabetic periph-eral neuropathy. Methods According to the Michigan diabetic neuropathy score (MDNS),the patients un-dergoing abdominal surgery were divided into four groups:non- diabetic group (group N,n = 21 ),the pa-tients with impaired glucose tolerance group (group A,n =1 9),the diabetic patients with MDNS score less or equal to 2 group (group B,n =21),the diabetic patients with MDNS score more than 2 group (group C,n =17).At the end of surgery the patients were injected Tropisetron 5 mg and Droperidol 1 mg,and connected Sufentanil intravenous analgesia pump for 48-hour analgesia continuously.The VAS score were recorded 4 h, 8 h,24 h,48 h after operation,and recored the total dosage of Sufentanil and the incidence of adverse reaction. Results Compared with group N and group A,patients of group C had higher VAS score at each time points,there were statistically significant difference.Compared of post-operative 24-h VAS score between group C and group B,there was statistically significant difference.Compared with group C,groups N,A and B had less 48-hour sufentanil consumption and there were statistically significant differences. Conclusion Compared with the patients without diabetes and the diabetes without neuropathy,the pain sensitivity of the diabetes with neuropathy was increased,and the quantity demanded of sufentanil on postoperative analgesia was greater.