氧化亚氮/氧气混合气体吸入镇痛在烧伤病人中的效果观察  

Application effect of the mixture of nitrous oxide/oxygenfor aspiration analgesia in burn patients

作　　者：李延仓[1] 李晓亮[1] 张建[1] 刘冰[1] 娄季鹤[1] LI Yancang;LI Xiaoliang;ZHANG Jian;LIU Bin;LOU Jihe(Department of Burn Unit,The First People’s Hospital of Zhengzhou,Zhengzhou,Henan 450004,China)

机构地区：[1]郑州市第一人民医院烧伤科,河南郑州450004

出　　处：《安徽医药》2020年第11期2157-2161,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学新技术引进项目(201303215)。

摘　　要：目的观察氧化亚氮/氧气(N2O/O2)混合气体吸入镇痛在烧伤病人中的应用效果。方法选取2013年2月至2015年2月郑州市第一人民医院收治的烧伤病人120例,采用双盲法随机分为观察组(创面换药时予以N2O/O2混合气体吸入镇痛,n=60)、对照组(创面换药时吸入氧气,n=60),其余治疗相同,以心电监护设备评估其在吸入N2O/O2前(T1)、吸入2 min(T2)、吸入5 min(T3)、吸入10 min(T4)的生命体征,比较两组换药前、换药中、换药后10 min的疼痛度[疼痛视觉模拟评分(VAS)]、焦虑程度[汉化版烧伤专用疼痛-焦虑量表(C-BSPAS)]、镇静程度(Ramsay镇静评分)、镇痛满意度,并记录其不良反应。结果观察组在T2、T3、T4时心率(HR)[T2(92.33±9.31)次/分比(96.16±9.53)次/分、T3(94.10±9.53)次/分比(98.78±9.76)次/分、T4(91.63±9.25)次/分比(97.45±9.88)次/分]、收缩压(SBP)[T2(124.45±12.67)mmHg比(129.35±13.40)mmHg、T3(127.79±12.55)mmHg比(133.47±13.68)mmHg、T4(124.13±12.68)mmHg比(129.55±12.67)mmHg]低于对照组,而血氧饱和度(SpO2)[T2(99.64±0.03)%比(95.84±0.39)%、T3(99.02±0.05)%比(97.25±0.34)%、T4(99.03±0.06)%比(96.88±0.45)%]高于对照组,观察组T2时舒张压(DBP)低于对照组[(71.38±7.26)mmHg比(74.58±7.62)mmHg,P<0.05];观察组换药中、换药后10 min VAS、C-BSPAS评分低于对照组(P<0.05);观察组镇静分级优于对照组(P<0.05);观察组镇痛满意度93.33%高于对照组80.00%(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论N2O/O2混合气体吸入镇痛应用于烧伤病人中有较好的镇痛、镇静效果,同时降低生命体征波动及焦虑程度,提高病人镇痛满意度,安全可靠,值得在临床推广应用。Objective To observe the application effect of the mixture of nitrous oxide/oxygen(N2O/O2)for aspiration analgesia in burn patients.Methods 120 cases of burn patients who were admitted to the First People’s Hospital of Zhengzhou from February 2013 to February 2015 were randomly divided into observation group(given mixture of N2O/O2 for aspiration analgesia at dressing change,n=60)and the control group(given inhalation of oxygen at dressing change,n=60)by double-blind method,and the rest treatmentswere the same.The ECG monitoring equipment was used to assessing vital signsbefore inhalation of N2O/O2(T1),at 2 min after inhalation(T2),at 5 min after inhalation(T3),at 10 min after inhalation(T4),the pain degree[pain visual analogue scale(VAS)],anxiety degree[Chinese version of burn-specific pain-anxiety scale(C-BSPAS)],degree of sedation(Ramsay sedation score),satisfaction degree with analgesia of the two groups before dressing change,during changing dressing,at 10 min after dressing change,the adverse reactions were recorded.Results The heart rate(HR)[T2(92.33±9.31)vs.(96.16±9.53),T3(94.10±9.53)vs.(98.78±9.76),T4(91.63±9.25)vs.(97.45±9.88)]and systolic blood pressure(SBP)[T2(124.45±12.67)mmHg vs.(129.35±13.40)mmHg,T3(127.79±12.55)mmHg vs.(133.47±13.68)mmHg,T4(124.13±12.68)mmHg vs.(129.55±12.67)mmHg]of the observation group were lower than those of the control group at T2,T3 and T4,while the oxygen saturation(SpO2)[T2(99.64±0.03)%vs.(95.84±0.39)%,T3(99.02±0.05)%vs.(97.25±0.34)%,T4(99.03±0.06)%vs.(96.88±0.45)%]was higher than that of the control group.The diastolic blood pressure(DBP)of the observation group was lower than that of the control group at T2[(71.38±7.26)mmHg vs.(74.58±7.62)mmHg,P<0.05].The scores of VAS and C-BSPAS in the observation group were lower than those in the control group during changing dressing and at 10 min after dressing change(P<0.05).The sedation grade of the observation group was better than that of the control group(P<0.05),the analgesiasatisfaction degree was highe

关 键 词：烧伤 镇痛 投药 吸入 氧化亚氮/氧气 混合气体吸入 

分 类 号：R644[医药卫生—外科学]