术后镇痛对老年应激反应水平及血液高凝状态的影响  

The effects of postoperative analgesia on stress response and hypercoagulation in the elderly

作　　者：赵启东[1] 田原[1] 张红光[1] 苏帆[1] 

机构地区：[1]山东中医药大学附属医院麻醉科,济南市250014

出　　处：《实用疼痛学杂志》2013年第4期259-263,共5页Pain Clinic Journal

基　　金：国家自然科学基金：81072960/H2902

摘　　要：目的观察术后镇痛对老年患者手术后应激反应水平和血液凝集状态的影响。方法选取行PCIA的手术患者。于术后记录其疼痛水平，据此分为镇痛良好组（P0组）和镇痛不全组（P1组），分析比较两组患者应激反应的强弱和凝血状态的高低。结果在术后24h和72h，P1组去甲肾上腺素和肾上腺素水平均明显高于PO组（P〈0．01，P〈0．01）。P1组纤维蛋白原和凝血酶一抗凝血酶复合物水平亦均明显高于PO组（P〈0．05，P〈0．01）。结论良好的术后镇痛可明显降低老年患者的应激反应水平，减轻其术后的血液高凝状态。Objective To investigate the effects of postoperative analgesia on stress response and hypercoagulation in the elderly. Methods The patients were scheduled to receive patient-con- trolled intravenous analgesia （PCIA） after surgery. Pain scores were recorded at 24 and 72 hours, by which the patients were subdivided into good analgesia group （P0） and incomplete analgesia group （P1）. The intensity of stress response and the coagulation status of group P0 were compared with group P1. Results The postoperative norepinephrine and epinephrine levels at 24 h （T2） and 72 h （T3） postoperatively in group P1 were significantly higher than those in group P0 （P〈0.01, P〈 0.01）. The FIB levels at T2 andT3 in group P1 were much higher than that in group P0 （P〈0.05）. The TAT at T2 andT3 in group P0 markedly decreased as compared with that in group P1 （P〈 0.01）. Conclusion Good postoperative analgesia can significantly reduce the stress response and the postoperative hypercoagulation in the elderly.

关 键 词：疼痛 手术后 镇痛 应激 高凝状态 老年人 

分 类 号：R619[医药卫生—外科学]