独一味联合地佐辛镇痛治疗对老年胆总管结石病人术后疼痛的影响  

Effect of Duyiwei combined with dezocine on postoperative pain in elderly patients with choledocholithiasis

作　　者：张家泉 李旺勇 孙杰 冯其柱 王琦 ZHANG Jiaquan;LI Wangyong;SUN Jie;FENG Qizhu;WANG Qi(Department of General Surgery,The Fourth Affiliated Hospital of Bengbu Medical College(Huainan First People's Hospital),Huainan,Anhui 232007,China)

机构地区：[1]蚌埠医学院第四附属医院(淮南市第一人民医院)普外科,安徽淮南232007

出　　处：《安徽医药》2022年第10期2094-2097,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的研究独一味联合地佐辛镇痛对老年胆总管结石病人术后的影响。方法选取淮南市第一人民医院2017年6月至2020年5月收治的年龄≥60岁的102例胆总管结石的病人,随机数字表法分为两组,对照组51例,术后给予0.25%地佐辛、阿扎司琼0.08 mg/mL行自控镇痛,负荷量2 mL,以2 mL/h为背景剂量持续泵入,单次剂量2 mL,锁定时间20 min。研究组51例,在对照组基础上口服独一味胶囊,3粒/次,3次/天,连服7 d。比较两组术后1 d、2 d、3 d数字分级法疼痛(NRS)评分,术后72 h静脉补救镇痛次数,镇痛泵(PCA泵)泵压次数,呕吐、头晕、切口出血发生率,病人镇痛效果满意度,血清皮质醇、醛固酮及C反应蛋白(CRP)含量。结果通过独立样本t检验和χ2检验分析,研究组术后1 d[(3.92±0.90)分比(5.49±4.68)分]、2 d[(3.37±1.13)分比(4.01±1.30)分]、3 d[(3.09±1.20)分比(3.98±1.60)分]NRS疼痛评分均低于对照组,差异有统计学意义(P<0.05);研究组手术后72 h静脉补救镇痛次数为4次低于对照组的11次,研究组PCA泵压次数为12次低于对照组的20次,研究组病人镇痛效果满意度评分[(4.37±0.77)分比(3.10±0.72)分]明显高于对照组,均差异有统计学意义(P<0.05);研究组术后1 d血清皮质醇[(417.65±13.56)nmol/L比(464.98±19.01)nmol/L]、醛固酮[(0.22±0.01)µg/L比(0.27±0.01)µg/L]及CRP含量[(102.20±11.83)mg/L比(104.26±12.67)mg/L]明显低于对照组,差异有统计学意义(P<0.05)。结论开腹胆总管切开取石术后的老年病人使用独一味联合地佐辛镇痛疗效确切,能增加病人满意度,改善术后应激及炎症反应,有临床应用的价值。Objective To study the effect of Duyiwei combined with dezocine analgesia on elderly patients with choledocholithiasis after surgery.Methods A total of 102 patients with choledocholithiasis aged≥60 years who were admitted to Huainan First People's Hospital from June 2017 to May 2020 were selected and randomly divided into two groups.The control group of 51 cases was given dezocine(0.25%)and azasetron(0.08 mg/mL)for patient-controlled analgesia after operation,with a loading volume of 2 mL,continuously pumped at a background dose of 2 mL/h,a single dose of 2 mL,and a lock-in time of 20 min.The 51 cases in the study group were given Duyiwei capsules on the basis of the control group,3 capsules/time,3 times/day,for 7 days.Comparing the two groups after 1 d,2 d and 3 d,the digital grading pain(NRS)scores,the times of intravenous rescue analgesia at 72 h after operation,the analgesic pump(patient-controlled analgesia,PCA)pumping times,the incidence of vomiting,dizziness,and incision bleeding,the patient satisfaction with analgesia effects,serum cortisol,aldosterone and C reactive protein(CRP)levels were compared between the two groups.Results Through independent samples t test andχ2 test analysis,the NRS pain scores at 1 d[(3.92±0.90)score vs.(5.49±4.68)score],2 d[(3.37±1.13)score vs.(4.01±1.30)score]and 3 d[(3.09±1.20)score vs.(3.98±1.60)score]in the study group were significantly lower than those in the control group(P<0.05).The number of intravenous rescue analgesia administrations at 72 hours after surgery in the study group was 4 times,which was lower than the 11 times in the control group.The time of PCA pumping in the study group was 12 times,which was lower than the 20 times in the control group.The analgesic effect satisfaction score of the patients in the study group[(4.37±0.77)points vs.(3.10±0.72)points]was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The levels of serum cortisol[(417.65±13.56)nmol/L vs.(464.98±19.01)nmol/L],aldos

关 键 词：镇痛药 疼痛 手术后 独一味胶囊 地佐辛 胆总管造口术 胆总管结石病 中西医结合 

分 类 号：R657.4[医药卫生—外科学]