氯胺酮预防性镇痛用于肠道肿瘤合并抑郁患者的疗效评价  

Clinical Efficacy of Ketamine Preventive Analgesia in Patients With Intestinal Tumors Combined Depression

作　　者：张江川 刘丰华 陈运良[1] 伍川 熊朝晖[1] ZHANG Jiangchuan;LIU Fenghua;CHEN Yunliang;WU Chuan;XIONGZhaohui(Department of Anesthesiology,The People's Hospital of Guang'an City,Guang'an Shichuan 638000,China;Department of Anesthesiology,West China Hospital of Sichuan University,Chengdu Shichuan 610000,China)

机构地区：[1]广安市人民医院麻醉科,四川广安638000 [2]四川大学华西医院麻醉科,四川成都610000

出　　处：《中国继续医学教育》2019年第1期76-78,共3页China Continuing Medical Education

基　　金：四川省医学会课题(S15032)

摘　　要：目的探讨氯胺酮预防性镇痛对肠道肿瘤合并抑郁患者术后抑郁评分与睡眠的影响。方法选择2015年5月—2017年5月,24项汉密尔顿抑郁评分(Hamilton depression scale,HDRS)≥20分,行腹腔镜下直、结肠癌根治术的肠道肿瘤合并抑郁患者80例,随机分为两组:氯胺酮预防性镇痛组(K组)和常规镇痛组(C组),每组各40例,K组手术前以氯胺酮预防性镇痛,C组行常规术后镇痛,观察两组患者的术后疼痛视觉模拟评分(visual analogue scale,VAS)、HDRS评分、匹兹堡睡眠质量指数(Pitsburgh Sleep Quality Index,PSQI)。结果与C组比较,K组患者术后VAS、HDRS评分与PSQI均较低,差异有统计学意义(P<0.05);与术前比较,K组患者术后HDRS评分与PSQI下降,差异有统计学意义(P <0.05)。结论氯胺酮预防性镇痛有较好的术后镇痛效果,可降低肠道肿瘤患者术后抑郁评分,改善睡眠质量。Objective To investigate the effect of postoperative depression score and sleep quality of ketamine preventive analgesia in patients with intestinal cancer.Methods From May2015to May2017,80intestinal neoplasms with depression patients for Hamilton Depression Scale(HDRS)≥20points undergoing laparoscopic radical resection of colon cancer were randomly divided into two groups:ketamine preventive analgesia group(group K)and conventional analgesia group(group C),40cases in each group.Group K was given preventive analgesia with ketamine before operation and group C with conventional postoperative analgesia.The Visual Analogue Scale(VAS),HDRS,Pitsburgh Sleep Quality Index(PSQI)of two groups were observed.Results Compared with group C,the VAS,HDRS and PSQI of postoperative were lower in group K(P<0.05).Compared with preoperation,the HDRS and PSQI were decreased in group K(P<0.05).Conclusion Ketamine preventive analgesia has better postoperative analgesic effect,which can reduce postoperative depression score and improve sleep quality in intestinal cancer patients.

关 键 词：氯胺酮 预防性镇痛 肿瘤 汉密尔顿抑郁评分 匹兹堡睡眠质量指数 疼痛视觉模拟评分 

分 类 号：R614[医药卫生—麻醉学]