纳洛酮联合芬太尼对胃癌术后患者胃肠功能的影响  

Effects of naloxone combined with fentanyl on gastrointestinal function in patients with gastric cancer

作　　者：李砚文[1] 孔树佳[2] 肖云[1] 王永顺[1] 殷婕[1] LI Yanwen;KONG Shujia;XIAO Yun;WANG Yongshun;YIN Jie(ICU,Yunnan Provincial Tumor Hospital,the Third Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650000,China;Department of Pharmacy,Yunnan Provincial Tumor Hospital,the Third Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650000,China)

机构地区：[1]昆明医科大学第三附属医院/云南省肿瘤医院重症医学科,云南昆明650000 [2]昆明医科大学第三附属医院/云南省肿瘤医院药剂科,云南昆明650000

出　　处：《检验医学与临床》2018年第13期1920-1922,1926,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨纳洛酮联合芬太尼对胃癌术后患者胃肠功能的影响。方法选择2012年6月至2016年6月云南省肿瘤医院收治的胃癌行根治性肿瘤切除术患者86例作为观察对象,采用随机数字表法均分为观察组和对照组,每组43例,术后两组患者均给予芬太尼静脉给药自控镇痛。观察组在此基础上给予硬膜外注入小剂量纳洛酮,对照给予等量生理盐水注入。对比两组患者术后不同时间点的VAS评分、术后肠鸣音恢复时间、排便时间、肛门排气时间、胃动力恢复时间及镇痛泵药物消耗量和芬太尼用量,统计术后并发症发生率。结果术后两组患者均出现轻微疼痛,术后4、8、12、24h观察组患者的疼痛评分均明显低于对照组,差异有统计学意义(P<0.05);观察组术后肠鸣音恢复时间、排便时间、肛门排气时间、胃动力恢复时间及术后1周镇痛泵药物消耗量和芬太尼用量均明显低于对照组,观察组术后并发症总发生率为9.30%,明显低于对照组的30.23%,上述差异均有统计学意义(P<0.05)。结论小剂量纳洛酮联合芬太尼可减少胃癌患者术后镇痛药物用量,减轻阿片类药物的不良反应,对患者术后胃肠功能的恢复具有积极意义。Objective To investigate the effect of naloxone combined with fentanyl on gastrointestinal function in patients with gastric cancer.Methods From June 2012 to June 2016,86 patients with radical gastrectomy were collected and randomly divided into observation group(n=43)and control group(n=43).Two groups of patients were given fentanyl intravenous-controlled analgesia.The observation group on this basis to give epidural injection of small doses of naloxone,control given the same amount of saline injection.The VAS score,postoperative bowel sounds recovery time,defecation time,anal exhaust time,gastric motility recovery time and analgesic pump drug consumption and fentanyl dosage were compared between the two groups at different time points.The incidence of disease was collected.Results The pain scores of the two groups were significantly lower than those of the control group at 4 h,8 h,12 h and 24 h after operation(P<0.05).The postoperative bowel disease.The time of analgesia,defecation time,anal exhaust time,recovery time of gastric motility and the consumption of analgesic pump and fentanyl were significantly lower than those of the control group in one week after operation.The total incidence of postoperative complications was 9.30%,which was significantly lower than that of the control group(30.23%),the difference was statistically significant(P<0.05).Conclusion Low dose of naloxone combined with fentanyl can reduce the dosage of analgesic drugs and reduce the side effects of opioids in patients with gastric cancer,which is of great significance to the recovery of gastrointestinal function.With clinical promotion value.

关 键 词：纳洛酮 芬太尼 胃癌 胃肠功能 

分 类 号：R656.6[医药卫生—外科学] R735.2[医药卫生—临床医学]