实用医院临床杂志
實用醫院臨床雜誌
실용의원림상잡지
PRACTICAL JOURNAL OF CLINICAL MEDICINE
2015年
4期
129-130,131
,共3页
吗啡%地佐辛%脊柱手术%自控镇痛
嗎啡%地佐辛%脊柱手術%自控鎮痛
마배%지좌신%척주수술%자공진통
Morphine%Dezocine%Spinal operation%Patient-controlled analgesia
目的：探讨地佐辛联合吗啡用于脊柱骨折全麻术后自控镇痛（patient controlled intravenous analgesia ，PCIA）的镇痛效果及不良反应。方法2011年1月至2014年1月我院全麻下行脊柱骨折内固定手术患者90例，采用随机数字法分为观察组及对照组各45例。两组术后均进行 PCIA，对照组予以吗啡，观察组予以地佐辛联合吗啡。比较两组患者术后3、6、12、24、48 h 的视觉模拟评分（VAS）、舒适度评分（BCS）、Ramsay 评分以及不良反应。结果术后3～24 h 各时间点观察组患者的Ramsay 评分均明显高于对照组，差异有统计学意义（P ＜0．05）；两组术后各时点 VAS 评分及 BCS 评分比较差异无统计学意义（P ＞0．05）；观察组并发症发生率为4．44％，明显低于对照组的22．22％，差异有统计学意义（χ2＝6．154，P ＜0．05）。结论吗啡联合地佐辛应用于脊柱骨折术后的静脉镇痛效果良好，且不良反应少，值得推广应用。
目的：探討地佐辛聯閤嗎啡用于脊柱骨摺全痳術後自控鎮痛（patient controlled intravenous analgesia ，PCIA）的鎮痛效果及不良反應。方法2011年1月至2014年1月我院全痳下行脊柱骨摺內固定手術患者90例，採用隨機數字法分為觀察組及對照組各45例。兩組術後均進行 PCIA，對照組予以嗎啡，觀察組予以地佐辛聯閤嗎啡。比較兩組患者術後3、6、12、24、48 h 的視覺模擬評分（VAS）、舒適度評分（BCS）、Ramsay 評分以及不良反應。結果術後3～24 h 各時間點觀察組患者的Ramsay 評分均明顯高于對照組，差異有統計學意義（P ＜0．05）；兩組術後各時點 VAS 評分及 BCS 評分比較差異無統計學意義（P ＞0．05）；觀察組併髮癥髮生率為4．44％，明顯低于對照組的22．22％，差異有統計學意義（χ2＝6．154，P ＜0．05）。結論嗎啡聯閤地佐辛應用于脊柱骨摺術後的靜脈鎮痛效果良好，且不良反應少，值得推廣應用。
목적：탐토지좌신연합마배용우척주골절전마술후자공진통（patient controlled intravenous analgesia ，PCIA）적진통효과급불량반응。방법2011년1월지2014년1월아원전마하행척주골절내고정수술환자90례，채용수궤수자법분위관찰조급대조조각45례。량조술후균진행 PCIA，대조조여이마배，관찰조여이지좌신연합마배。비교량조환자술후3、6、12、24、48 h 적시각모의평분（VAS）、서괄도평분（BCS）、Ramsay 평분이급불량반응。결과술후3～24 h 각시간점관찰조환자적Ramsay 평분균명현고우대조조，차이유통계학의의（P ＜0．05）；량조술후각시점 VAS 평분급 BCS 평분비교차이무통계학의의（P ＞0．05）；관찰조병발증발생솔위4．44％，명현저우대조조적22．22％，차이유통계학의의（χ2＝6．154，P ＜0．05）。결론마배연합지좌신응용우척주골절술후적정맥진통효과량호，차불량반응소，치득추엄응용。
Objective To investigate the effect of dezocine combined with morphine after general anesthesia for spinal fracture on patient-controlled analgesia (PCA) and their adverse reactions .Methods Ninety patients underwent spinal fracture internal fixa -tion operation from Jan.2011 to Jan.2014 in our hospital.They were randomly divided into observation and control groups ,45 cases in each group.The control group was given morphine while the observation group was treated with dezocine combined with morphine .The visual analog scale (VAS),Bruggman comfort scale (BCS),Ramesay score and adverse reaction conditions were compared after 3,6, 12,24 and 48 h between the two groups.Results After 3-24 hours of operation,the Ramsay score at different time pints in the observa -tion group was significant higher than that in the control group (P <0.05).There was no significant difference in the VAS score and BCS scores at different time points between the two groups .In the observation group,the incidence of complications was 4.44% that was significantly lower than that in the control group (22.22%) (χ2 =6.154,P <0.05).Conclusion Morphine combined with dezocine used in spinal fracture postoperative analgesia and sedative has a good effect ,and can reduce the adverse reactions .It is worthy of popu-larization.
