患者中医证型因素对羟考酮用于腹腔镜子宫肌瘤剔除术后镇痛效果的影响  

Effects of Traditional Chinese Medicine syndrome factors on analgesic efficacy of oxycodone after laparoscopic hysteromyomectomy

作　　者：苏保义[1] 朱旭[1] Su Baoyi;Zhu Xu(Department of Anesthesiology,Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,China)

机构地区：[1]厦门市中医院麻醉科,361009

出　　处：《中华麻醉学杂志》2020年第2期203-205,共3页Chinese Journal of Anesthesiology

摘　　要：目的探讨患者中医证型因素对羟考酮用于腹腔镜子宫肌瘤剔除术后镇痛效果的影响。方法择期全麻下行腹腔镜下子宫肌瘤剔除术患者200例,年龄20~59岁,ASA分级Ⅰ或Ⅱ级,BMI 18~30 kg/m2,根据中医证型分为4组:肾虚血瘀型(A组,n=65)、湿热瘀阻型(B组,n=53)、气滞血瘀型(C组,n=43)和痰湿瘀结型(D组,n=39)。采用疼痛数字评分法(NRS)评价术后疼痛程度,NRS评分≥4时,滴定式静脉注射羟考酮至NRS评分<4分(负荷量),行PCIA,镇痛泵用药:羟考酮100 mg,用生理盐水配至100 ml,参数设置:背景输注速率1 ml/h,PCA剂量1 ml,锁定时间10 min。记录羟考酮负荷量及术后第1和2天用量。结果与A组和C组比较,B组和D组羟考酮负荷量及术后第1和2天用量增加(P<0.05);B组与D组比较、A组与C组比较,上述指标差异无统计学意义(P>0.05)。结论患者中医证型因素可影响羟考酮用于腹腔镜子宫肌瘤剔除术后镇痛效果,湿热瘀阻型和痰湿瘀结型子宫肌瘤患者羟考酮术后镇痛的效力较弱。Objective To investigate the effects of Traditional Chinese Medicine(TCM)syndrome factors on the analgesic efficacy of oxycodone after laparoscopic hysteromyomectomy.Methods Two hundred female patients,of American Society of Anesthesiologists physical statusⅠorⅡ,aged 20-59 yr,with body mass index of 18-30 kg/m2,scheduled for elective laparoscopic hysteromyomectomy under general anesthesia,were divided into 4 groups according to the TCM syndrome types:kidney deficiency and blood stasis type group(group A,n=65),damp-heat stagnation type group(group B,n=53),Qi stagnation and blood stasis type group(group C,n=43),and phlegm and dampness stagnation type group(group D,n=39).Postoperative pain was assessed using the numerical rating scale(NRS).When the NRS score≥4,oxycodone was slowly injected intravenously in a titrated manner until the NRS score<4(loading dose).The patient-controlled intravenous analgesia solution contained oxycodone 100 mg in 100 ml of normal saline.The patient-controlled intravenous analgesia pump was set up to deliver a 1-ml bolus dose with a 10-min lockout interval and background infusion at a rate of 1 ml/h.The loading dose of oxycodone and consumption of oxycodone on 1st and 2nd days after operation were recorded.Results Compared with A and C groups,the loading dose of oxycodone and consumption of oxycodone on 1st and 2nd days after operation were significantly increased in B and D groups(P<0.05).There were no significant difference in the parameters mentioned above between group B and group D and between group A and group C(P>0.05).Conclusion The TCM syndrome factors can affect the analgesic efficacy of oxycodone after laparoscopic hysteromyomectomy,and the postoperative analgesic efficacy of oxycodone is weakened comparatively in the patients of damp-heat stagnation type and of phlegm and dampness stagnation type.

关 键 词：羟可酮 镇痛 病人控制 子宫肌瘤切除术 腹腔镜检查 医学 中国传统 

分 类 号：R737.33[医药卫生—肿瘤]