摘要
目的:探究醋氯芬酸联合瑞芬太尼对乳腺癌患者术后的镇痛效果及对睡眠质量的影响。方法:选取2021年1月至2022年2月济南市第三人民医院实施根治术的乳腺癌患者80例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组40例。2组患者术后启动镇痛泵,对照组患者泵入瑞芬太尼2μg/kg维持镇痛,观察组在对照组用药的基础上联用醋氯芬酸片,0.1 g/次,2次/d,维持镇痛。根据视觉模拟疼痛量表(VAS)评估2组患者术后3 h、6 h、12 h和24 h的疼痛程度,比较2组患者手术前后血清炎性因子水平、术后不良反应发生率和睡眠质量。结果:观察组患者术后3 h、6 h、12 h和24 h的VAS评分均显著低于对照组,2组比较差异均有统计学意义(均P<0.05);术后1 d、3 d,2组患者血清CRP、TNF-α和IL-6水平较手术前显著升高,且对照组显著高于观察组,2组比较差异均有统计学意义(均P<0.05);术后5 d,2组患者上述血清炎性因子水平与治疗前比较,差异均无统计学意义(均P>0.05);观察组患者恶心呕吐、头晕、皮肤瘙痒和目眩甚至惊厥等不良反应发生率均显著低于对照组;夜间觉醒次数、睡眠潜伏期、REM睡眠潜伏期、REM睡眠期比例、总睡眠时间和PSQI评分均显著优于对照组,2组比较差异均有统计学意义(均P<0.05)。结论:醋氯芬酸联合瑞芬太尼可有效缓解乳腺癌患者术后疼痛,改善炎性因子水平,降低不良反应发生率,提高其睡眠质量。
Objective:To investigate the effect of aceclofenac combined with remifentanil on postoperative analgesia and sleep quality in patients with breast cancer.Methods:A total of 80 breast cancer patients who underwent radical resection in Health Department of Ji’nan Third People’s Hospital from January 2021 to February 2022 were selected as the research objects,and were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The analgesia pump was started in the two groups after operation,the control group was infused with remifentanil at 2μg/kg to maintain analgesia,and the observation group was treated with aceclofenac tablets 0.1 g/time,2 times/d on the basis of the control group,maintenance of analgesia.According to the numerical grading scoring method,the pain degree at 3 h,6 h,12 h and 24 h after operation,the degree of pain’s interference with daily activities,the incidence of postoperative adverse reactions and sleep quality were statistically analyzed in the two groups.Results:The VAS scores of the observation group were significantly lower than those of the control group at 3 h,6 h,12 h and 24 h after operation(P<0.05);At 1 d and 3 d after operation,the levels of serum CRP,TNF-αand IL-6 in the two groups were significantly higher than those before operation,and the control group was significantly higher than the observation group,the differences were statistically significant(P<0.05);On the 5th day,there was no significant difference in the above indicators between the two groups before treatment and between the groups(P>0.05);nausea and vomiting,dizziness,itching and dizziness Even the incidence of adverse reactions such as convulsions were significantly lower than those in the control group;the number of nighttime awakenings,sleep latency,REM sleep latency,REM sleep period ratio,total sleep time and PSQI score were significantly better than those in the control group,and the differences were statistically significant(P<0.05).C
作者
王海霞
WANG Haixia(Health Department of Ji′nan Third People′s Hospital,Ji′nan 250132,China)
出处
《世界睡眠医学杂志》
2022年第9期1610-1613,共4页
World Journal of Sleep Medicine
关键词
醋氯芬酸
瑞芬太尼
乳腺癌
术后镇痛
睡眠质量
Aceclofenac
Remifentanil
Breast cancer
Postoperative analgesia
Sleep quality
