盐酸曲马多联合TST治疗痔疮的临床效果及对患者术后疼痛、应激反应的影响分析  

Clinical effect of oral administration of tramadol hydrochloride combined with TST in treating hemorrhoids and its influence on postoperative pain and stress response of patients

作　　者：姚旭光 Yao Xuguang(East Henan branch of Henan provincial people's hospital,Shangqiu,Henan,476800,China.)

机构地区：[1]河南省人民医院豫东分院,河南商丘476800

出　　处：《齐齐哈尔医学院学报》2022年第2期140-143,共4页Journal of Qiqihar Medical University

摘　　要：目的分析口服盐酸曲马多联合选择性吻合器痔切闭术(TST)治疗痔疮的临床效果及对术后患者疼痛、应激反应的影响。方法选择2018年1月—2020年1月本院肛肠外科收治的TST手术治疗的痔病患者121例作为研究对象,随机数表法分为研究组(61例)与对照组(60例)两组。对照组与研究组术后分别给予洛索洛芬钠与盐酸曲马多,均治疗4 d。对比两组术后0.5 h、1 h、3 h、24 h、36 h的疼痛评分(VAS),治疗前后的一氧化氮(NO)、肾上腺皮质激素(ACTH)、超氧化物歧化酶(SOD)及围术期不良事件。结果术后0.5 h两组的VAS评分差异无统计学意义(t=0.617,P>0.05);相较于术后0.5 h,术后1 h、3 h、24 h、36 h时两组VAS评分均有所升高,研究组术后各时间点VAS评分均低于对照组,差异有统计学意义(t=2.960、5.883、9.071、2.821,P<0.05);治疗前两组NO、ACTH、SOD差异无统计学意义(t=0.071、0.984、0.937,P>0.05),治疗后研究组NO、ACTH、SOD低于对照组(t=5.319、3.989、7.589,P<0.05);两组总不良事件率差异无统计学意义(χ2=0.139,P>0.05)。结论相比洛索洛芬钠,TST痔疮微创手术中应用盐酸曲马多具有更良好的镇痛与镇静效果,可有效减轻患者术后疼痛感及手术应激反应。Objective To analyze the clinical effect of oral administration of tramadol hydrochloride combined with tissue-selecting therapy stapler(TST)in the treatment of hemorrhoids and its influence on postoperative pain and stress response.Methods From January 2018 to January 2020,121 patients with hemorrhoids treated by TST in our hospital were selected as study objects,and they were randomly divided into study group(61 cases)and control group(60 cases)according to random number table method.The control group and study group were given loxoprofen sodium and tramadol hydrochloride for 4 days.The pain score(VAS)at 0.5,1,3,24 and 36 h after operation,preoperative and postoperative nitric oxide(no),adrenocortical hormone(ACTH),and superoxide dismutase(SOD),and adverse events were compared between the two groups.Results There was no significant difference in VAS score between the two groups at 0.5 h after operation(t=0.617,P>0.05).Compared with that at 0.5 h after operation,the VAS scores of the two groups increased at 1,3,24 and 36 h after operation,and the VAS scores of the study group at each time point after operation were lower than those of the control group,the differences were statistically significant(t=2.960,5.883,9.071 and 2.821,P<0.05).Before treatment,there was no significant difference in NO,ACTH and SOD between the two groups(t=0.071,0.984,0.937,P>0.05).After treatment,NO,ACTH and SOD in the study group were lower than those in the control group(t=5.319,3.989,7.589,P<0.05).There was no significant difference in the total adverse event rate between the two groups(χ2=0.139,P>0.05).Conclusions Compared with loxoprofen sodium,tramadol hydrochloride applied in TST hemorrhoids minimally invasive surgery has better analgesic and sedative effect,and could effectively reduce postoperative pain and surgical stress reaction.

关 键 词：选择性吻合器痔切闭术 盐酸曲马多 痔病 微创手术 

分 类 号：R657.1[医药卫生—外科学]