舒芬太尼复合多拉司琼用于肝细胞癌微波消融术的镇痛分析  

Analgesic Analysis of Sufentanil Combined with Dolasetron for Microwave Ablation of Hepatocellular Carcinoma

作　　者：黄俊风[1] 邓显智 李小波[2] 许德明[1] 蔡建荣[1] 安鲁毅 HUANG Junfeng;DENG Xianzhi;LI Xiaobo;XU Deming;CAI Jianrong;AN Luyi(Department of Anesthesiology,the Affiliated Hospital of Putian University,Putian,Fujian Province,351100 China;Department of Radiotherapy,Union Hospital Affiliated to Fujian Medical University,Fuzhou,Fujian Province,350001 China;Department of Anesthesiology,Fuzhou First Hospital affiliated to Fujian Medical University,Fuzhou,Fujian Province,350000 China)

机构地区：[1]莆田学院附属医院麻醉科,福建莆田351100 [2]福建医科大学附属协和医院放疗科,福建福州350001 [3]福建医科大学附属福州市第一医院麻醉科,福建福州350000

出　　处：《中外医疗》2023年第19期14-19,共6页China & Foreign Medical Treatment

基　　金：福建省科技厅(2020Y4010)。

摘　　要：目的评价舒芬太尼复合止吐药静脉推注用于CT定位下肝细胞癌微波消融术的疗效及可行性。方法简单随机选取2021年1月—2022年6月莆田学院附属医院疼痛科收治的90例行肝细胞癌微波消融手术的患者为研究对象,按照随机数表法分为3组,每组30例。A组为对照组予以常规吸氧;B组为镇痛组,采用术前10 min常规吸氧后静脉推注舒芬太尼负荷剂量0.05μg/kg及术前3 min静脉推注舒芬太尼0.15μg/kg进行镇痛处理;C组为镇痛复合止吐组,采用术前10 min静脉推注多拉司琼12.5 mg后按照B组的镇痛方法给药。记录3组术前、术中的视觉模拟评分法(Visual Analogue Scale,VAS)、经皮动脉血氧饱和度(percutaneous arterial oxygen saturation,SpO_(2))、心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)的变化及呕吐例数的情况。结果B组VAS评分(3.2±1.4)分、C组(3.4±1.2)分显著低于A组的(7.5±1.5)分,差异有统计学意义(F=93.823,P<0.001)。C组术中呕吐患者有1例,显著低于B组的16例,差异有统计学意义(P<0.001)。3组术前、术中的SpO_(2)、HR、MAP变化对比,差异无统计学意义(P>0.05)。结论舒芬太尼复合止吐药静脉推注用于CT定位下肝细胞癌微波消融术的疗效安全可靠,镇痛完全且并发症少。Objective To evaluate the efficacy and feasibility of intravenous injection of sufentanil combined with antiemetics for microwave ablation of hepatocellular carcinoma under CT location.Methods From January 2021 to June 2022,90 patients with hepatocellular carcinoma who underwent microwave ablation in the Department of Pain,Affiliated Hospital of Putian University from January 2021 to June 2022 were simply and randomly selected as the study subjects.They were divided into 3 groups according to the random number table method,30 cases in each group.Group A was given routine oxygen inhalation as the control group;group B was the analgesia group,sufentanil loading dose of 0.05μg/kg was injected intravenously 10 min before operation and sufentanil 0.15μg/kg was injected intravenously 3 min before operation.Group C was analgesia combined with antiemetic group,and 12.5 mg of dolasetron was intravenously injected 10 min before operation,and then administered according to the analgesic method of group B.The changes of Visual Analogue Scale(VAS),percutaneous arterial oxygen saturation(SpO_(2)),heart rate(HR),mean arterial pressure(MAP)and the number of vomiting cases were recorded before and during operation.Results The VAS score of group B(3.2±1.4)points and group C(3.4±1.2)points were significantly lower than that of group A(7.5±1.5)points,and the difference was statistically significant(F=93.823,P<0.001).There was 1 case of vomiting in group C,which was significantly lower than that in group B(16 cases),and the difference was statistically significant(P<0.001).There was no statistically significant difference in the changes of SpO_(2),HR and MAP between the three groups before and during operation(P>0.05).Conclusion Intravenous injection of sufentanil combined with antiemesis drug for microwave ablation of hepatocellular carcinoma under CT location is safe and reliable,complete analgesia and few complications,which is worthy of promotion.

关 键 词：舒芬太尼 肝细胞癌 微波消融 镇痛 

分 类 号：R4[医药卫生—临床医学]