消炎痛栓不同时间给药对腹腔镜胆囊切除术后镇痛效果的影响  

INFLUENCE ON ANALGESIA EFFECT OF INDOMETHACIN SUPPOSITORY IN DIFFERENT TIME FOR THE LC POSTOPERATIVE PATIENTS

作　　者：张玉珍 魏万梅 刘惠勤 王宇[2] 

机构地区：[1]中核兰铀公司职工医院外科,甘肃省兰州市730065 [2]首都医科大学附属北京友谊医院普外科

出　　处：《中国煤炭工业医学杂志》2015年第3期413-416,共4页Chinese Journal of Coal Industry Medicine

基　　金：北京市科技新星计划(编号:2008A086)

摘　　要：目的观察消炎痛栓不同时间直肠给药对腹腔镜胆囊切除术(LC)患者术后镇痛及康复的效果。方法 79例择期行LC手术患者,随机分为A组、B组和C组,排除术后使用静脉或硬膜外镇痛泵患者11例。A组(24例)术前1h直肠给予消炎痛栓100mg,B组(22例)术后2h直肠给予消炎痛栓100mg,C组(22例)术后疼痛要求用止痛剂时直肠给予消炎痛栓100mg。于术后2、4、6、8、12及24h时采用视觉模拟评分法(VAS)评价患者疼痛程度,记录使用其他止痛药的次数,采用WHO疼痛程度分级标准判断术日、次日和术后第二天的舒适度,记录肛门排气时间。结果三组患者术后不同时间相同时间点术后疼痛VAS评分组间比较均差异有统计学意义(P<0.01);三组患者术后使用其他止痛药比较:B组与C组之间比较差异无统计学意义(P>0.05);A组与B组、A组与C组之间比较差异有统计学意义(P<0.05);三组患者术后舒适度比较:术日、次日A组舒适度最高,B组次之,C组最差,三组之间比较差异有统计学意义(P<0.01),术后第二天三组比较差异无统计学意义(P>0.05);三组患者术后肛门排气时间比较,A组与B组之间比较差异无统计学意义(P>0.05);B组与C组、A组与C组之间比较差异有统计学意义(P<0.01)。结论术前1h消炎痛栓直肠给药对LC手术患者术后镇痛效果明显优于术后2h和术后疼痛时给药,且术日、次日舒适度显著提高,肛门排气时间明显缩短,促进患者早日康复。Objective To observe the effect of indomethacin suppository via rectal for postoperative patients with laparoscopic cholecystectomy（LC）in different time on analgesia and rehabilitation.Methods Totally79 patients underwent elective LC surgery,were randomly divided into group A,group B and group C,among them,11 cases were excluded out of intravenous or postoperative epidural analgesia pump patients.Group A（24 cases）accepted indomethacin suppository 100 mg via rectal pre-operation1 hour,group B（22 cases）for indomethacin suppository 100 mg via rectal 2 hours after operation,group C（22 cases）was treated with indomethacin suppository 100 mg via rectal when postoperative pain and asked for analgesia.The pain degree of patients in postoperative 2,4,6,8,12 and 24 hours was evaluated by using visual analogue scale（VAS）,and the number of using other painkillers was recorded.The comfort degree on operation day,first and second day after operation by WHO pain classification standard was judged,the anus exhaust time was recorded.Results The postoperative pain VAS scores of different time postoperatively at the same point were of significant difference among three groups（P〈0.01）;On postoperative use other painkillers,there were statistical significance between group A and group B,group A and group C（P〈0.05）,but no statistically significant between group B and group C（P〉0.05）.On postoperative comfort degree on the day and after day was in proper order top of group A,group B and group C,and with significant difference（P〈0.01）.On postoperative anal exhaust time,there were statistical significance between group A and group C,group Band group C,besides group A and group B（P〈0.01）.Conclusions The effect of postoperative analgesia for indomethacin suppository rectal medication at preoperative 1 hour is obviously better than LC surgery 2 hours after surgery and/or postoperative pain,and on the day and after day,comfort level increases significantly,anal exhaust time significantly shorte

关 键 词：消炎痛栓 胆囊切除术 直肠给药 术后镇痛 

分 类 号：R657.4[医药卫生—外科学]