CAJ | 학술논문

目的：通过比较不同剂量的盐酸氢吗啡酮用于患者术后镇痛效果的研究，探究盐酸氢吗啡酮在术后镇痛中的最有效剂量。方法选择40例择期食管癌患者随机分为 A 组（n =10）：盐酸氢吗啡酮4 mg，昂丹司琼8 mg，氟比洛芬酯200 mg，生理盐水加至100 ml；B 组（n =10）：盐酸氢吗啡酮6 mg，昂丹司琼8 mg，氟比洛芬酯200mg，生理盐水加至100 ml；C 组（n =10）：盐酸氢吗啡酮8 mg，昂丹司琼8 mg，氟比洛芬酯200 mg，生理盐水加至100 ml；D 组（n =10）：盐酸氢吗啡酮10 mg，昂丹司琼8 mg，氟比洛芬酯200mg，生理盐水加至100 ml。各组均选用电子输注泵，流速设置2 ml/ h，一次 PCIA 剂量2 ml，锁定时间15 min，持续镇痛48 h。结果盐酸氢吗啡酮 A、B 组与盐酸氢吗啡酮 C、D 组相比，镇痛评分（VAS）、镇静评分有统计学差异（P≤0.05）。C 组与 D 组相比，镇痛评分（VAS）、镇静评分、按压次数均无明显的统计学差异，但 C 组病人费用少于 D 组。结论盐酸氢吗啡酮 C 组用于食管癌根治术后静脉镇痛，效果确切，不良反应少。
목적：통과비교불동제량적염산경마배동용우환자술후진통효과적연구，탐구염산경마배동재술후진통중적최유효제량。방법선택40례택기식관암환자수궤분위 A 조（n =10）：염산경마배동4 mg，앙단사경8 mg，불비락분지200 mg，생리염수가지100 ml；B 조（n =10）：염산경마배동6 mg，앙단사경8 mg，불비락분지200mg，생리염수가지100 ml；C 조（n =10）：염산경마배동8 mg，앙단사경8 mg，불비락분지200 mg，생리염수가지100 ml；D 조（n =10）：염산경마배동10 mg，앙단사경8 mg，불비락분지200mg，생리염수가지100 ml。각조균선용전자수주빙，류속설치2 ml/ h，일차 PCIA 제량2 ml，쇄정시간15 min，지속진통48 h。결과염산경마배동 A、B 조여염산경마배동 C、D 조상비，진통평분（VAS）、진정평분유통계학차이（P≤0.05）。C 조여 D 조상비，진통평분（VAS）、진정평분、안압차수균무명현적통계학차이，단 C 조병인비용소우 D 조。결론염산경마배동 C 조용우식관암근치술후정맥진통，효과학절，불량반응소。
Objective:To make clinical study of different doses of hydromorphone for patient-controlled intravenous an-algesia(PCIA),and explore hydromorphone postoperative intravenous analgesia methods and the optimal dose. Methods:Forty patients undergoing elective abdominal surgery were selected and divided into group A(n = 10):hydromorphone 4 mg,ondansetron 8 mg,Kay Fun 200mg,group B( n = 10):hydromorphone 6 mg,ondansetron 8 mg,Kay Fun 200mg, group C( n = 10):hydromorphone 4 mg,ondansetron 8 mg,Kay Fun 200mg,group D(n = 10):hydromorphone 10mg, ondansetron 8 mg,Kay Fun 200mg,and each therapy was diluted to 100ml with 0. 9% NS. Four groups were controlled by electronic infusion pumps,with injection infusion speed of 2 - 4ml/ h,PCA dose of 2 - 4ml,lockout time of 30min. The analgesia(VAS)and sedation(Ramsay)scores at 4,6,8,12,24,36,48h,the frequency of PCA compression,as well as the occurrence of nausea,vomitting and adverse reactions were recorded. Results:Compared with hydromorphone C,D group,hydromorphone AB group had higher VAS scores and(Ramsay)scores(P≤0. 05). Cmpared to Group D,VAS scores and(Ramsay)scores in Group C were not statisticslly significant(P > 0. 05)However,the cost of patients in group C was less than that in group D. Conclusion:The use of Hydromorphone C group in PCIA shows satisfactory analgesic effi-cacy and good safety in patients after undergoing abdominal operation.