舒芬太尼超前镇痛联合心理干预对乳腺癌根治术患者术后的影响  

Effect of sufentanil advance analgesia combined with psychological intervention on postoperative patients undergoing radical breast cancer surgery

作　　者：谭洪[1] 蒋奕红[1] 石泉[1] 梁维[1] 李敏[1] TAN Hong;JIANG Yihong;SHI Quan;LIANG Wei;LI Min(Anesthesiology Department,Affiliated Hospital of Guilin Medical University,Guilin,Guangxi 541001,China)

机构地区：[1]桂林医学院附属医院麻醉科,广西桂林541001

出　　处：《中国医学工程》2022年第7期82-86,共5页China Medical Engineering

摘　　要：目的探讨舒芬太尼超前镇痛联合心理干预对乳腺癌根治术患者的术后影响。方法选取112例18~80岁在桂林医学院附属医院行乳腺癌根治术的女性患者,随机分为4组,每组28例。A组为综合组:舒芬太尼超前镇痛+心理支持疗法(PPST);B组仅有PPST,无超前镇痛;C组为舒芬太尼超前镇痛无PPST;D组为传统常规插管全身麻醉,未行任何超前镇痛及PPST。术后2 h、12 h、24 h对患者进行视觉模拟评分法(VAS)评分;记录患者不良反应及术后镇痛药使用情况。结果A组苏醒时间显著低于C组、D组,B组苏醒时间显著低于C组、D组,C组苏醒时间显著低于D组(P<0.05)。经重复测量方差分析,不同时间点VAS评分差异有统计学意义(F=929.712,P<0.001);12 h、24 h时VAS评分显著低于2 h时(P<0.001);四组患者VAS评分差异有统计学意义(F=153.199,P<0.001);四组患者VAS评分的变化趋势差异有统计学意义(F=23.939,P<0.001)。A组首次手术后使用止痛药时间显著高于B组、C组、D组,B组首次手术后使用止痛药时间显著低于C组、D组,C组首次手术后使用止痛药时间显著低于D组(P<0.05)。结论舒芬太尼超前镇痛联合PPST能有效缓解乳腺癌患者术后疼痛,是一种更安全、有效的镇痛方法。【Objective】To explore the postoperative effects of sufentanil advance analgesia combined with psychological intervention on patients undergoing radical breast cancer surgery.【Methods】A total of 112 female patients aged 18-80 years old who underwent radical breast cancer surgery in our hospital were randomly divided into 4 groups,28 patients in each group.Group A was a comprehensive group:sufentanil prehyperalgesia+psychological intervention;group B was a psychological support group only,i.e.,PPST,without prehyperalgesia;group C was a sufentanil prehyperalgesia group without PPST;group D was a conventional intubated general anesthesia without any prehyperalgesia and psychological support.The patients were scored by Visual Analogue Scale(VAS)at 2,12 and 24 h after surgery;adverse reactions and postoperative analgesic use were recorded.【Results】The awakening time in group A was significantly lower than that in groups C and D;the awakening time in group B was significantly lower than that in groups C and D;and the awakening time in group C was significantly lower than that in group D(P<0.05).The VAS scores at 2 h,12 h and 24 h after extubation were compared among the four groups,and the results were analyzed by repeated measures ANOVA as follows.The VAS scores at different time points were different(F=929.712,P<0.001).The VAS scores at 12 h and 24 h were significantly lower than those at 2 h(P<0.001).The use of pain medication after the first surgery was significantly higher in group A than in groups B,C and D;the time to use pain medication after the first surgery was significantly lower in group B than in groups C and D;the time to use pain medication after the first surgery was significantly lower in group C than in group D(P<0.05).【Conclusion】Sufentanil advance analgesia combined with psychological support treatment can effectively relieve the postoperative pain of breast cancer patients.It is a safer and more effective method of analgesia.

关 键 词：舒芬太尼 超前镇痛 心理支持疗法 乳腺癌患者 

分 类 号：R737.9[医药卫生—肿瘤]