氟比洛芬酯与帕瑞昔布镇痛效果对比及术后疼痛高危因素调查  

Analgesic Effect Comparison of Furbiprofen Axetil and Parecoxib Sodium in Operative Patients and Investigation on High Risk Factors of Postoperative Pain

作　　者：赵琴[1,2] 陶宜富[1] 朱余兵[1] 蒋纯志[1] 杨蓊勃[1] 于锋[2] 朱君荣[1] 

机构地区：[1]南京医科大学附属南京医院临床药学室,南京210006 [2]中国药科大学临床药学教研室

出　　处：《中国药师》2013年第8期1189-1192,共4页China Pharmacist

基　　金：南京市医学科技发展项目(编号:YKK12086);江苏省药学会医院药学基金(编号:JS2012-03)

摘　　要：目的:比较上肢骨折内固定术中应用氟比洛芬酯或帕瑞昔布的镇痛效果与不良反应,并调查分析手术后疼痛的可能高危因素。方法:采用回顾性调查方法,将于南京某三甲医院行上肢骨折内固定术的375例患者,按病历资料记载的术中使用镇痛药物的种类,分为氟比洛芬酯100 mg组(A组)、氟比洛芬酯50 mg组(B组)、帕瑞昔布40mg组(C组)和术中未用药物组(D组),比较四组间镇痛有效性和不良反应的指标;同时采用多元线性回归分析主要的疼痛高危因素。结果:术后1 h,A、B两组VAS评分显著低于C组(P<0.05),术后3 h,A、B、C三组VAS评分差异无统计学意义(P>0.05),术后6,12 h,A、B两组VAS评分显著高于C组(P<0.05);术后A、B两组VAS评分差异无统计学意义(P>0.05);与D组相比,A、B、C三组术后各时间点VAS评分均明显降低(P<0.05)。四组患者不良反应发生例数差异无统计学意义(P>0.05)。手术切口长度及手术时间与患者术后疼痛程度的增加相关(P<0.05)。结论:氟比洛芬酯和帕瑞昔布均能减轻术后疼痛,以氟比洛芬酯起效更快,而帕瑞昔布中长期镇痛效果更优。而且氟比洛芬酯50 mg剂量与100mg组有效性和安全性相当。同时有效缩短手术切口长度和手术时间对减轻患者术后疼痛程度可能有帮助。Objective： To compare the analgesia effect and the adverse reactions of flurbiprofen axetil and parecoxib sodium in the patients undergoing upper limb fracture internal fixation surgery,＇ and further study the high risk factors of postoperative pain. Method： A retrospective study was adopted. The included 375 patients were divided into four groups according to the analgesic drugs applied during the procedure： flurbiprofen axetil 100rag （group A）, flurbiprofen axetil 50rag （group B）, parecoxib sodium 40mg （group C ） and the control group （ group D）. The analgesic efficacy and the adverse drug reactions of the four groups were compared. Meanwhile, the major risk factors of postoperative pain were analyzed with multifactor line regression method. Result： The VAS scores in group A and group B were lower than that in group C in lh after the surgery and the VAS scores in group A and group B were higher than that in group C in 6h and 12h（P 〈 0.05）. The VAS scores after the surgery showed no significant difference between group A and group B. Furthermore, there was significant difference in the VAS scores after the surgery among group A, B, C and D（ P 〈 0.05）. The vari- ance among the data of adverse drug reactions was not statistically significant （P 〉 0.05 ）. Meanwhile, the muhifactor line regression showed the incision length and the operation time might increase the risk of postoperative pain. Conclusion： Both parecoxib sodium and flurbiprofen axetil injections applied in the patients undergoing upper limb fracture surgery can alleviate postoperative pain. Flurbi- profen axetil provides the analgesic effect with less time, while parecoxib shows better pain-relief effect in a long-term period. In the study, 50rag flurbiprofen axetil obtains analgesic effect and safety as successfully as 100rag flurbiprofen axetil. Meanwhile, shortening the incision length and the operation time can help relieving postoperative pain.

关 键 词：氟比洛芬酯 帕瑞昔布 上肢骨折内固定手术 术中镇痛方案 疼痛高危因素 

分 类 号：R971.1[医药卫生—药品]