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出 处:《中国肛肠病杂志》2008年第11期43-45,共3页Chinese Journal of Coloproctology
摘 要:为了观察局部注射克泽普联合盐酸奈福泮在肛门病术后镇痛的临床效果,将行肛门病手术治疗的成人患者600例随机分为4组,每组150例,静脉镇痛采用一次性微量连续镇痛泵以2ml/h进行。Ⅰ组:单纯局部注射克泽普5ml;Ⅱ组:局部注射克泽普5ml,静脉镇痛配方:盐酸奈福泮240mg加芬太尼0.1μg/(kg·h);Ⅲ组:局部注射克泽普5ml,静脉镇痛配方:芬太尼0.3μg/(kg·h);Ⅳ组:单纯静脉镇痛,配方同Ⅲ组。观察各组患者48h的镇痛评分(VAS)及不良反应的发生情况。结果显示,4h内各组VAS评分无显著性差异(P〉0.05),而4h后的评分,Ⅰ组明显高于Ⅱ、Ⅲ组(P〈0.01)。Ⅳ组亦高于Ⅱ、Ⅲ组(P〈0.05)。Ⅱ组的不良反应发生率明显少于Ⅲ、Ⅳ组(P〈0.05)。所有患者镇痛期间均无呼吸抑制等严重并发症发生。结果表明,采用局部注射克泽普联合盐酸奈福泮静脉用药用于肛门病术后镇痛,效果显著,优于单模式的镇痛方法,可明显减少阿片类药物的用量及降低不良反应的发生率。For the objective of observing the clinical effect of local injection of Kezepu plus nefotam hydrochloride in the postoperative analgesta of anal operations. The 600 patients who had undergone anal operations were randomised into 4 groups, 150 in each group. Patients in group I received local injection of Kezepu(5ml) only;patients in group Ⅱ received local injection of Kezepu(5ml) plus intravenous pumping of nefotam hydrochloride 240mg,2ml/hour,and fentanyl 0. 1μg/kg · hour;patients in group Ⅲ received local injection of Kezep(5ml) plus intravenous pumping of fentanyl 0. 3μg/kg · hour; and patients in group IV received intravenous pumping of fentanyl 0.3μg/kg · hour only. The analgesic score and adverse reactions were observed during postoperative 48 hours. As results, there was no obvious differences in analgesic score among the 4 groups during the postoperative 4 hours( P 〈0.05) ;while after postoperative 4 hours,the analgesic score was higher in group Ⅰ than in group Ⅱ and Ⅲ ( P 〈0. 01),and that in group Ⅳ was also higher than that in group Ⅱ and Ⅲ ( P 〈0.05);the adverse reaction occurrence rate in group Ⅱ was much lower than that in group Ⅲ and Ⅳ( P 〈0.05) ;and no severe complications occurred during the analgesic period. It is concluded that the analgesic efficacy of local injection of Kezepu plus nefotam pumping is prominent, and the combined analgesic practice can reduce the occurrence rate of adverse reactions.
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