地佐辛复合舒芬太尼PCIA镇痛用于大面积烧伤切削痂自体皮移植术后患者的效果分析  

Clinical Efficacy of Dezocine Combined with Sufentanil in Application of PCIA Analgesia in Patients with Massive Burns after Escharectomy and Autologous Skin Grafting

作　　者：肖博夫 张兆祥 易成刚 张栋梁 XIAO Bo-fu;ZHANG Zhao-xiang;YI Cheng-gang;ZHANG Dong-liang(Department of Plastic Surgery,Xijing Hospital of PLA Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院整形外科,西安710032

出　　处：《解放军医药杂志》2021年第11期81-84,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金(81901980)。

摘　　要：目的观察地佐辛复合舒芬太尼用于大面积烧伤切削痂自体皮移植术后患者静脉患者自控镇痛(PCIA)的效果。方法选择2018年1月—2020年12月我院78例大面积烧伤行切削痂自体皮移植术患者,根据术后镇痛方法的不同均分为观察组和对照组,术后患者均采用PCIA,观察组术后予地佐辛复合舒芬太尼镇痛,对照组术后仅单用舒芬太尼镇痛。记录2组48 h内PCIA追加次数;比较2组术后1、6、12、24、48 h视觉模拟评分法(VAS)评分、Ramsay镇静评分;比较2组术前及术后1、24、48 h血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平;记录2组药物不良反应发生情况;评价2组术前、术后1周正性负性情绪量表(PANAS)评分。结果给药48 h内,观察组PCIA追加次数明显少于对照组(P<0.01)。观察组术后6、12、24、48 h VAS评分均显著低于对照组同时点(P<0.01)。2组术后1、6、12、24、48 h Ramsay镇静评分比较差异无统计学意义(P>0.05)。观察组术后24、48 h血清TNF-α、IL-6水平均显著低于对照组同时点(P<0.05,P<0.01)。观察组不良反应总发生率为12.82%低于对照组的33.33%(P<0.05)。术后1周,2组PANAS负性情绪评分较术前降低,且观察组负性情绪评分低于对照组(P<0.05)。结论地佐辛复合舒芬太尼用于大面积烧伤切削痂自体皮移植术后患者PCIA效果良好,有利于减轻患者炎症反应、降低不良反应发生率、调节负性情绪。Objective To observe clinical efficacy of Dezocine combined with Sufentanil in application of patient-controlled intravenous analgesia(PCIA)in patients with massive burns after escharectomy and autologous skin grafting.Methods A total of 78 patients with massive burns who had undergone escharectomy and autologous skin grafting between January 2018 and December 2020 were divided into observation group and control group according to different postoperative analgesia methods.All the patients were treated with PCIA after operation.Observation group was treated with Dezocine combined with Sufentanil after operation,while control group was treated with Sufentanil only after operation.Numbers of additional PCAI within 48 h were recorded in two groups.Visual analogue scale(VAS)and Ramsay Sedation scores after operation for 1,6,12,24 and 48 h were compared between two groups.Serum levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)before and after operation for 1 h,24 h and 48 h were compared between two groups.Incidence rates of adverse drug reactions were recorded,and scores of positive and negative affect scale(PANAS)before and after operation for 1 week were evaluated in two groups.Results Within 48 h after administration,the number of additional PCIA in observation group was significantly less than that in control group(P<0.01).VAS scores after operation for 6 h,12 h,24 h and 48 h in observation group were significantly lower than those in control group at the same time point(P<0.01)There were no significant differences in Ramsay Sedation scores after operation for 1 h,6 h,12 h,24 h and 48 h between two groups(P>0.05).TNF-αand IL-6 levels after operation for 24 h and 48 h were significantly lower than those in control group at the same time point(P<0.05,P<0.01).The total incidence rate of adverse reactions in observation group(12.82%)was significantly lower than 33.33%in control group(P<0.05).After operation for 1 week,PANAS negative emotion scores were significantly lower than those before operation i

关 键 词：烧伤 切削痂自体皮移植 静脉患者自控镇痛 地佐辛 舒芬太尼 

分 类 号：R644[医药卫生—外科学]