氯诺昔康超前镇痛结合心理支持疗法对老年癌症患者术后镇痛效果的观察  

Observation of the postoperative analgesic effect of Lornoxicam preemptive analgesia combined with psychotherapy for elderly cancer patients

作　　者：刘玲[1] 李锦成[1] 

机构地区：[1]天津医科大学附属肿瘤医院麻醉科,天津市肿瘤防治重点实验室,天津市300060

出　　处：《中国肿瘤临床》2013年第11期664-667,共4页Chinese Journal of Clinical Oncology

摘　　要：目的：寻求对老年癌症患者更安全有效超前镇痛结合心理支持的综合手术后镇痛方法。方法：选取ASAⅠ-Ⅱ级择期行肿瘤手术患者120例，随机分为4组，每组30例。A组为氯诺昔康＋心理治疗：患者于手术前30rain静注氯诺昔康16mg（生理盐水稀释至10mL），并由专人按标准程序行围术期心理支持疗法（PPST）；B组为氯诺昔康：患者仅于手术前30min静注氯诺昔康16mg（生理盐水稀释至10mL），未行PPST；C组为心理支持：患者仅行PPST，于手术前30min静注生理盐水10mL；D组为传统静脉全麻。术后2、4、8、24、48h对患者进行疼痛数字分级法评分（NRS）；记录患者不良反应及术后镇痛药使用情况。结果：A、B组术后2、4、8、24、48h的NRS显著低于C、D组（P〈0．05），A、B组之间比较差异无统计学意义（P〉0．05），c、D组术后4、8h比较，C组NRS低于D组（P〈0．05）。患者最早要求使用镇痛药物时间的A、B组明显长于C、D组（P〈0．01），两组间比较A组明显长于B组（P〈0．05），C组明显长于D组（P〈0．05）；48h内行4组各时段镇痛药的需求例数比较，A、B组明显少于C、D组（P〈0．05），A、B组问及C、D组间差异无统计学意义（P〉0．05）。4组患者术后不良反应差异无统计学意义。结论：氯诺昔康超前镇痛结合心理支持疗法对老年癌症患者术后镇痛效果较未结合心理支持疗法更为满意，是一种安全、有效的术后镇痛方法。Objective： This work aims to identify a more effective and safer comprehensive pain-relief method of preemptive an- algesia, which could be combined with psychological support for postoperative elderly cancer patients. Methods： A total of 120 pa- tients with ASAⅠ-Ⅱ selective operation were randomly divided into four groups （n=30）. In Group A （lomoxicam plus psychological support）, intravenous injection of 16 mg lomoxicam was administered to the patients 30 rain before surgery （diluted to 10 mL with nor- mal saline）. The perioperative psychological support therapy （PPST） for this group was conducted by a special medical staff in accor- dance to the standard procedure. In Group B （lomoxicam only）, 16 mg lomoxicam （diluted to 10 mL with the saline） was injected intra- venously without the PPST 30 min before surgery. In Group C （psychological support only）, PPST was implemented, and a 10 mL sa- line was injected 30 min before surgery. In Group D （traditional intravenous anesthesia）, the numeric rating scale （NRS） of pain was used at 2, 4, 8, 24, and 48 h after surgery. The adverse reactions and use of other painkillers were recorded. Results： The NRS was sig- nificantly lower in Groups A and B compared with that in Groups C and D at 2, 4, 8, 24, and 48 h after the surgery （P〈0.05）. No statisti- cally significant difference was found （P〉0.05） between Groups A and B. The NRS was obviously lower in Group C than in Group D at 4 and 8 h after surgery （P〈0.05）. The initial time required for the use of the analgesics was significantly longer in Groups A and B com- pared with Groups C and D （P〈0.05）. Comparing the number of cases that needed the analgesics at various intervals of time among the four groups within 48 h, the number of cases was obviously less in Groups A and B than in Groups C and D （P〈0.05）. No significant difference was observed between the case number of all the groups （P〈0.05）. No statistical significance was observed in the

关 键 词：氯诺昔康 超前镇痛 心理支持疗法 老年癌症患者 

分 类 号：R614[医药卫生—麻醉学]