摘要
目的:研究联合药物镇痛对甲状腺术后疼痛的镇痛效果和不良反应。方法:研究对象选取行甲状腺手术患者129例,采用随机数字法将其分为三组,每组43例。43例患者术后静脉滴注地佐辛镇痛(地佐辛组),43例患者术后静脉滴注舒芬太尼镇痛(舒芬太尼组),43例患者采用地佐辛联合舒芬太尼静脉滴注镇痛(联合组),比较三组患者术后不同时间疼痛评分(UAS评分)、镇静评分(Ramesy评分)及肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平,同时比较三组的不良反应发生率。结果:联合组术后2 h、4 h、8 h、12 h及24 h的VAS评分均显著低于地佐辛组和舒芬太尼组,差异有统计学意义(P<0.05);联合组术后2 h和8 h的Ramesy镇静评分明显低于地佐辛组和舒芬太尼组,差异有统计学意义(P<0.05);联合组在T 1、T 2、T 3、T 4的TNF-α和IL-6水平均明显低于地佐辛组和舒芬太尼组,差异有统计学意义(P<0.01);联合组的恶心呕吐、皮肤瘙痒及头痛、头昏等不良反应发生率均明显低于地佐辛组和舒芬太尼组,差异有统计学意义(P<0.05)。结论:地佐辛联合舒芬太尼镇痛可有效缓解甲状腺术后的疼痛感,同时减少镇静评分,有效预防手术造成的炎性反应,且不良反应少,是一种高效的镇痛模式,值得在临床推广。
Objective To study the analgesic effect and adverse reaction of combined drug analgesia on pain after thyroidectomy.Method 129 patients who underwent thyroidectomy in our hospital were selected and divided into three groups:A,B and C by random number method,43 cases in each group.Group A received intravenous drip of dizosin for analgesia after operation,group B received intravenous drip of sufentanil for analgesia after operation,and group C received intravenous drip of dizosin and sufentanil for analgesia after operation.Meanwhile,pain score,sedation score,TNF-alpha and IL-6 levels were compared,and the incidence of various adverse reactions was compared.Results The VAS scores of group C at 2,4,8,12 and 24 hours after operation were significantly lower than those of group A and B,the difference was statistically significant(P<0.05).The Ramesey sedation scores of group C at 2 and 8 hours after operation were significantly lower than those of group A and B,the difference was statistically significant(P<0.05).The levels of TNF-a and IL-6 in group C at T1,T2,T3 and T4 were significantly lower than those of group A and B,the difference was statistically significant(P<0.01).The incidence of nausea,vomiting,itching and headache and dizziness in group C were significantly lower than those in group A and B,the difference was statistically significant(P<0.05).Conclusion Dizosin combined with sufentanil analgesia can effectively alleviate the pain after thyroidectomy,reduce the sedation score,effectively prevent the inflammatory reaction caused by surgery,and have fewer adverse reactions.It is an effective analgesic mode,and it is worth popularizing in clinical practice.
作者
王益群
刘怿敏
谢皇
王白云
梁娜
钟焕晖
WANG Yi-qun;LIU Yi-min;XIE Huang(Department of Anesthesiology,Affiliated Nanhua Hospital of University of South China,Hengyang 421002,China;Department of Urology Surgery,The Second Affiliated Hospital of South China University,Hengyang 421001,China)
出处
《吉林医学》
CAS
2020年第2期288-291,共4页
Jilin Medical Journal
基金
湖南省卫生健康委2019年度科研计划课题项目[项目编号:B2019206]
衡阳市2018年指导性项目[项目编号:S2018F9031025331]
