帕瑞昔布在肺癌手术多模式镇痛效果及其对凝血功能的影响  

Multimodal Analgesia Effect of Parecoxib in Lung Cancer Ssurgery and Its Influence on Coagulation Function

作　　者：万松[1] 陈晶[1] 陈力勇[1] 吴彬[2] 徐峰 

机构地区：[1]第三军医大学大坪医院麻醉科,重庆400042 [2]重庆医科大学附属第一医院麻醉科,重庆400042 [3]重庆市东南医院麻醉科,重庆410085

出　　处：《现代生物医学进展》2015年第22期4310-4313,共4页Progress in Modern Biomedicine

基　　金：重庆市医药科研计划项目(14JJ2092)

摘　　要：目的:研究帕瑞昔布在胸部肺癌手术后多模式镇痛效果及其对凝血功能的影响。方法:自2012年1月到2013年12月期间,全麻复合硬膜外麻醉下实施肺癌手术病人120例,分为3组,对照组(C组)和不同帕瑞昔布钠处理组(P1组和P2组)。对照组采用硬膜外镇痛,P1此基础上术前静脉用帕瑞昔布,P2组在P1基础上术后加用帕瑞昔布。观察三组手术时间、术中出血量、术中瑞芬太尼及术后吗啡用量、不同时间段VAS和术前术后凝血功能。结果:C组、P1和P2组术中出血量三组间的差异有统计学意义,P2组出血量最少(p<0.05)。C组、P1和P2组术中瑞芬太尼和术后吗啡使用剂量差异有统计学意义(P均<0.05)。C组、P1组和P2组术后6个月时间内疼痛发生率和6个月时间内疼痛发生天数差异有统计学意义(P均<0.05)。术中PT、APTT在三组间的差异有统计学意义(P<0.05)。结论:帕瑞昔布可降低病人开胸术后慢性疼痛综合征的发生,增加凝血功能,减少吗啡用量,且不增加不良反应发生几率,临床应用安全性可靠。Objective： To research the multimodal analgesia effect ofparecoxib in lung cancer surgery and its influence on blood coagulation function. Methods： From January 2012 to December 2013, 120 patients with lung cancer surgery under general anesthesia I compound with epidural anesthesia were divided into three groups, control group （group C） and different paranal yesterday the sodium treatment group （P1 and P2 group）. C group adopts epidural analgesia, and P1 is performed with parecoxib through vein preoperatively of the basis of C group. P2 was with parecoxib postoperatively on the basis of P1. The operation time, intraoperative blood loss, intraoperative fentanyl and postoperative morphine consumption, different times VAS and preoperative coagulation function after surgery were observed and compared. Results： Bleeding amount of group C, P1 and P2 group showed statistically difference （P〈0.05）, and P2 group blood loss was minimum. C group, P1 and P2 intraoperatie red fentanyl and postoperative morphine use dose difference was statistically significant （P〈 0.05）. Incidence of postoperative pain and sustain days of pain within six months time had statistically significant difference （ all p values〈0.05）. The difference of intraoperative PT, APTT had differences between three groups（p〈0.05）. Conclusions： Parecoxib can reduce the occurrence of postoperative chronic chest pain syndrome, increase blood coagulation function, may be less bleeding, and reduce the dosage of morphine. It does not increase the risk adverse reactions and it is safety and reliable in clinic.

关 键 词：肺癌 多模式镇痛 帕瑞昔布 开胸术后慢性疼痛综合征 凝血功能 

分 类 号：R734.2[医药卫生—肿瘤] R614[医药卫生—临床医学]