酮咯酸氨丁三醇联合芬太尼在嵌顿痔术后的镇痛效果  

Clinical observation of ketorolac tromethamine combined with fentanyl for postoperative analgesia of incarcerated hemorrhoids

作　　者：陈稳 戴光耀[1] 杨永强 艾燕红 CHEN Wen;DAI Guangyao;YANG Yongqiang(Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市人民医院,050011

出　　处：《河北医药》2023年第14期2175-2178,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究及发展指导计划(编号:191460883)。

摘　　要：目的探究酮咯酸氨丁三醇联合芬太尼在嵌顿痔术后镇痛的临床效果。方法选取2018年5月至2020年5月肛肠外科收治的嵌顿痔患者98例,按照随机数字法分成观察组与对照组,每组49例。对照组应用芬太尼为术后静脉镇痛用药,观察组应用芬太尼联合酮咯酸氨丁三醇为术后镇痛药物。比较2组患者术后的疼痛程度[视觉模拟评分(VAS)]、血流动力学情况、术后康复和并发症情况。结果术后6 h、第1天和第2天,2组患者的VAS评分组内对比有统计学意义(P<0.05),且观察组的VAS评分均优于对照组(P<0.05)。2组患者的血流动力学指标比较差异无统计学意义(P>0.05)。观察组的总有效率和并发症发病率优于对照组(P<0.05)。结论酮咯酸氨丁三醇联合芬太尼能在短时间内有效降低嵌顿痔术后镇痛程度,加快患者的术后康复并有效降低术后并发症发生率,且对患者血流无明显影响,具有良好的安全性。Objective To explore the clinical effect of ketorolac tromethamine combined with fentanyl for postoperative analgesia of incarcerated hemorrhoids.Methods A total of 98 patients with incarcerated hemorrhoids admitted to the anorectal surgery department of our hospital from May 2018 to May 2020 were selected.They were randomly divided into observation group and control group,with 49 patients in each group.Fentanyl,and fentanyl combined with ketorolac tromethamine were given to patients of control group and observation group for postoperative intravenous sedation,respectively.The pain degree assessed by the Visual Analogue Scale(VAS),hemodynamics,postoperative rehabilitation and complications before and after treatment were compared between groups.Results There were significant differences in the VAS scores at 6 h,1 day and 2 days postoperatively compared with the preoperative ones in both groups(P<0.05),which were significantly better in the observation group than those in the control group(P<0.05).There were no significant differences in hemodynamic indexes between the two groups(P>0.05).The total effective rate was significantly higher,while the incidence of complications was significantly lower in the observation group than those in the control group(P<0.05).Conclusion Ketorolac tromethamine combined with fentanyl is safe that can effectively improve the clinical efficacy of postoperative analgesia of incarcerated hemorrhoids and the postoperative recovery,and reduce the incidence of complications without significant effects on the blood flow.

关 键 词：酮咯酸氨丁三醇 芬太尼 嵌顿痔 术后镇痛 

分 类 号：R657.18[医药卫生—外科学]