中外医疗
中外醫療
중외의료
China Foreign Medical Treatment
2015年
25期
1-3
,共3页
帕瑞昔布%瑞芬太尼%腹腔镜%胆囊切除术
帕瑞昔佈%瑞芬太尼%腹腔鏡%膽囊切除術
파서석포%서분태니%복강경%담낭절제술
Parecoxib%Remifentanil%Laparoscope%Cholecystotomy
目的：对帕瑞昔布超前镇痛对瑞芬太尼全凭静脉麻醉腹腔镜胆囊切除术的麻醉用量及术后疼痛的影响进行分析探讨。方法将该院2014年1-12月收治的93例患者随机分为I组(对照组)、II组(超前镇痛用药)及III组(术后用药镇痛),每组31例患者,对比3组患者的疼痛程度、血浆P物质(substance P)、白细胞介素6(IL-6)及不良反应发生率。结果3组患者术后12 h及24 h的VAS评分均明显低于术后1 h,差异有统计学意义(P<0.05)。 II组患者术后阿片类药物使用率明显少于I组及III组(P<0.05)。手术结束后及术后24 h,II组患者的IL-6水平明显低于I组及III组(P<0.05)。3组患者手术前后的血浆P物质浓度及不良反应发生率差异无统计学意义(P>0.05)。结论对腹腔镜胆囊切除术患者手术前静脉注射帕瑞昔布进行超前镇痛能有效减少术后阿片类药物用量,抑制患者体内的IL-6的释放,缓解患者疼痛,在临床上值得推广应用。
目的：對帕瑞昔佈超前鎮痛對瑞芬太尼全憑靜脈痳醉腹腔鏡膽囊切除術的痳醉用量及術後疼痛的影響進行分析探討。方法將該院2014年1-12月收治的93例患者隨機分為I組(對照組)、II組(超前鎮痛用藥)及III組(術後用藥鎮痛),每組31例患者,對比3組患者的疼痛程度、血漿P物質(substance P)、白細胞介素6(IL-6)及不良反應髮生率。結果3組患者術後12 h及24 h的VAS評分均明顯低于術後1 h,差異有統計學意義(P<0.05)。 II組患者術後阿片類藥物使用率明顯少于I組及III組(P<0.05)。手術結束後及術後24 h,II組患者的IL-6水平明顯低于I組及III組(P<0.05)。3組患者手術前後的血漿P物質濃度及不良反應髮生率差異無統計學意義(P>0.05)。結論對腹腔鏡膽囊切除術患者手術前靜脈註射帕瑞昔佈進行超前鎮痛能有效減少術後阿片類藥物用量,抑製患者體內的IL-6的釋放,緩解患者疼痛,在臨床上值得推廣應用。
목적：대파서석포초전진통대서분태니전빙정맥마취복강경담낭절제술적마취용량급술후동통적영향진행분석탐토。방법장해원2014년1-12월수치적93례환자수궤분위I조(대조조)、II조(초전진통용약)급III조(술후용약진통),매조31례환자,대비3조환자적동통정도、혈장P물질(substance P)、백세포개소6(IL-6)급불량반응발생솔。결과3조환자술후12 h급24 h적VAS평분균명현저우술후1 h,차이유통계학의의(P<0.05)。 II조환자술후아편류약물사용솔명현소우I조급III조(P<0.05)。수술결속후급술후24 h,II조환자적IL-6수평명현저우I조급III조(P<0.05)。3조환자수술전후적혈장P물질농도급불량반응발생솔차이무통계학의의(P>0.05)。결론대복강경담낭절제술환자수술전정맥주사파서석포진행초전진통능유효감소술후아편류약물용량,억제환자체내적IL-6적석방,완해환자동통,재림상상치득추엄응용。
Objective To study the dosage of preemptive analgesia with Parecoxib and its effect on postoperative pain in patients undergoing laparoscopic cholecystectomy with total intravenenous anesthesia. Methods Ninety-three cases admitted in our hospital from January 2014 to December 2014 were randomly divided into group I (control group), group II treated by drugs for preemptive analgesia and group III treated by drugs for postoperative analgesia with 31 cases in each. The pain degree, plasma substance P, interleukin 6(IL-6) and incidence of side effects were compared between the three groups. Results The VAS score in the 3 groups at 12 hours and 24 hours after operation were much lower than those at 1 hour after operation, P<0.05. The postoperative opioid drugs use rate was obviously lower in group II than that in group I and group III, P<0.05. The IL-6 level was much lower in group II than that in group I and group III at the end of surgery and at 24h after surgery, P<0.05. The difference in the plasma substance P between the 3 groups before and after operation was not statistically significant, P>0.05. No statistically significant difference was found in the incidence of side effects between the 3 groups, P>0.05. Conclusion For patients undergoing laparoscopic cholecystec-tomy, intravenous injection of Parecoxib before the surgery for preemptive analgesia can effectively reduce the dosage of opioid drugs used after surgery, inhibit the release of IL-6 and alleviate the pain, so it is worthy of clinical application and promotion.
