帕瑞昔布钠预处理对慢性乙型肝炎肝硬化行脾脏手术患者镇痛与凝血功能影响的研究  

Influence of of parecoxib sodium pretreatment on analgesia and coagulation function in patients with chronic hepatitis B cirrhosis undergoing liver spleen operation

作　　者：陈祥剑 张雪松[1] 王利[1] 

机构地区：[1]上海市公共卫生临床中心麻醉科,257034

出　　处：《检验医学与临床》2016年第6期757-759,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨帕瑞昔布钠预处理对慢性乙型肝炎肝硬化行脾脏手术患者镇痛与凝血功能的影响。方法选取2012年1月至2015年2月本院收治的拟行脾切除手术的慢性乙型肝炎肝硬化患者100例。将患者分为研究组(n=50)与对照组(n=50),研究组患者在麻醉前10min时给予帕瑞昔布钠40mg静脉注射,对照组患者在麻醉前10min时给予生理盐水4mL静脉注射。比较术后24h两组患者的使用舒芬太尼静脉自控镇痛的按泵次数、使用剂量,两组患者的不良反应及术后不同时间点的凝血酶时间(TT)、凝血酶原时间(PT)、血小板(PLT)及纤维蛋白原(FIB)水平。结果术后24h研究组患者使用舒芬太尼静脉自控镇痛的按泵次数少于对照组,差异有统计学意义(t=5.0,P<0.001);不同时间点两组患者的TT、PT、PLT及FIB差异无统计学意义(P>0.05)。结论帕瑞昔布钠能减少慢性乙型肝炎肝硬化行脾脏手术患者镇痛药物的用量,且不影响患者的凝血功能。Objective To explore the influence of parecoxib sodium pretreatment on analgesia and coagulation function in the patients with chronic hepatitis B cirrhosis undergoing liver spleen operation.Methods A total of 100 cases of chronic hepatitis B cirrhosis undergoing splenectomy in our hospital from January 2012 to February 2015 were selected and divided into the research group（n=50）and control group（n=50）.The research group was given parecoxib sodium 40 mg by intravenous injection at 10 min before anesthesia,while the control group was intravenously injected by normal saline 4mL at 10 min before anesthesia.Then the pressing pump times during sufentanil self-control vein analgesia,use amount of sufentanil,adverse reactions at postoperative 24 h,and thrombin time（TT）,prothrombin time（PT）,platelet（PLT）count and fibrinogen（FIB）levels at different postoperative time points were compared between the two group.Results The pressing pump times within postoperative 24 hduring sufentanil self-control vein analgesia in the research group was less than that in the control group,the difference was statistically significant（t=5.0,P〈0.001）;TT,PT,PLT count and fibrinogen had no statistical differences between the two groups（P〉0.05）.Conclusion Parecoxib sodium can decrease the dosage of analgesic drugs in the patients with chronic hepatitis B cirrhosis undergoing spleen operation,moreover without affecting the coagulant function.

关 键 词：帕瑞昔布钠 乙型肝炎肝硬化 镇痛 凝血 

分 类 号：R575.2[医药卫生—消化系统]