帕瑞昔布钠对肝炎肝硬化患者术后镇痛效果及凝血功能的影响  

Effects of parecoxib on postoperative analgesia and blood coagulation in patients with hepatitis cirrhosis

作　　者：张维峰[1,2] 殷国平[1,2] 王佳[1,2] 张春明[1,2] 仲艳玲[1,2] 

机构地区：[1]南京市第二医院 [2]东南大学附属第二医院麻醉科,江苏省210003

出　　处：《江苏医药》2015年第2期181-183,共3页Jiangsu Medical Journal

摘　　要：目的探讨麻醉诱导前应用帕瑞昔布钠在肝炎肝硬化患者术后镇痛效果及对凝血功能的影响。方法择期行脾切除断流手术的肝炎肝硬化患者40例随机均分为两组,P组于麻醉前10min静脉注射帕瑞昔布钠40mg,C组应用等体积生理盐水。两组术毕均行舒芬太尼静脉自控镇痛(PCIA)。记录术后24h内PCIA泵按压次数,计算舒芬太尼总量,观察不良反应发生情况。检测用药前、用药后30min和12h的凝血酶原时间(PT)、凝血酶时间(TT)、激活部分凝血酶原时间(APTT)、纤维蛋白原(Fib)和血小板计数(Plt)。结果 P组术后24h内PCIA泵按压次数、有效按压次数、恶心、呕吐发生率和舒芬太尼总量均少于C组(P<0.05)。两组各时间点PT、TT、APTT、Fib和Plt比较均无统计学差异。结论肝炎肝硬化患者麻醉诱导前应用帕瑞昔布钠40mg可减少术后镇痛药用量及不良反应的发生,且不影响凝血功能。Objective To investigate the effects of parecoxib before anesthesia induction on postoperative analgesia and blood coagulation in the patients with hepatitis cirrhosis.Methods Forty patients with hepatitis cirrhosis under general anesthesia were equally randomized into two groups of P（given intravenous injection of parecoxib 40 mg at 10 min before anesthesia）and C（given same volume of normal saline as control）.Postoperative patient-controlled intravenous analgesia（PCIA）was carried out with sufentanil in two groups.The number of PCA compression,sufentanil consumption and the side effects were recorded within 24 hafter operation.The prothrombin time（PT）,thrombin time（TT）,activated partial thromboplastin time（APTT）,fibrogen（Fib）and platelet（Plt）were measured before and at 30 min and 12 hafter operation.Results The number of PCA compression,sufentanil consumption and the side effects within 24 hafter operation were all less in group P than those in group C（P〈0.05）.There were no significant differences in PT,TT,APTT,Fib and Plt between two groups at each time point.Conclusion Intravenous injection of parecoxib 40 mg before anesthesia can reduce the dose of postoperative analgesic drugs and side effects without significant adverse effect on blood coagulation in the patients with hepatitis cirrhosis.

关 键 词：帕瑞昔布钠 术后镇痛 凝血功能 肝炎肝硬化 

分 类 号：R614[医药卫生—麻醉学]