氟比洛芬酯在颅脑损伤患者镇痛治疗中的临床应用效果观察及安全性分析  

Effect and safety of flurbiprofen axetil in the analgesic treatment of patients with craniocerebral injury

作　　者：毛君 荣玉 李炎根 熊登喜 赵鹏[1] 查正江[1] MAO Jun;RONG Yu;LI Yangen;XIONG Dengxi;ZHAO Peng;ZHA Zhengjiang(Department of Neurosurgical Intensive Care Unit,Anqing Municipal Hospital,Anqing 246000,Anhui,China)

机构地区：[1]安庆市立医院,神经外科重症病区,安庆246000

出　　处：《中国临床药理学与治疗学》2023年第9期1056-1060,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:观察氟比洛芬酯用于颅脑损伤患者术后镇痛治疗的效果及安全性。方法:选取2021年5月至2023年5月在安庆市立医院神经外科收住的急性颅脑损伤术后患者60例,随机分为氟比洛芬酯组(氟比洛芬+芬太尼镇痛)及芬太尼组(芬太尼镇痛),镇痛目标CPOT评分≤3分。观察两组患者镇痛起效时间、48 h内芬太尼用量,以及镇痛治疗期间恶心呕吐、上消化道出血、心动过缓、低血压、呼吸抑制的发生次数。检测术前及术后24 h、48 h血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、神经元特异性烯醇化酶(neuron specific enolase,NSE)和S100β蛋白水平。结果:两组患者性别、年龄、BMI、入院格拉斯哥评分(GCS)等一般资料无统计学差异。镇痛达到CPOT评分≤3分目标值,氟比洛芬酯组需要的时间较芬太尼组短(P<0.05);48h内氟比洛芬酯组患者使用芬太尼总量较芬太尼组减少(P<0.05);两组患者在术后恶心呕吐、上消化道出血、心动过缓及低血压等不良反应方面无统计学差异(P>0.05);术后24 h及48 h时间点,氟比洛芬酯组CRP、IL-6、TNF-α、NSE、S100β水平均较芬太尼组显著降低(P<0.05)。结论:氟比洛芬酯可减少颅脑损伤患者镇痛芬太尼用量,并具有抗炎减轻脑损伤效应,可有效、安全地应用于颅脑损伤患者镇痛管理。AIM:To observe the efficacy and safety of flurbiprofen axidate in postoperative analgesia in patients with craniocerebral injury.METHODS:A total of 60 patients with acute craniocerebral injury admitted to the Department of Neurosurgery in our hospital from May 2021 to May 2023 were selected.They were randomly divided into flurbiprofen axetil group(flurbiprofen+fentanyl analgesia)and fentanyl group(fentanyl analgesia),and the CPOT score of analgesia target was≤3 points.The onset time of analgesia,the dosage of fentanyl within 48 h,and the occurrence times of nausea and vomiting,upper gastrointestinal hemorrhage,bradycardia and hypotension during analgesia treatment were observed in the two groups.Serum CRP,IL-6,TNF-α,NSE and S100βprotein levels were detected before and 24 h and 48 h after the operation.RESULTS:There were no significant differences in gender,age,BMI,admission GCS score between the two groups.When analgesia reached the target value of CPOT score≤3 points,the time required for flurbiprofen ester group was shorter than that of fentanyl group(P<0.05),and the total amount of fentanyl used in flurbiprofen axetil group was lower than that of control group within 48 hours(P<0.05).There were no significant differences in postoperative nausea and vomiting,upper gastrointestinal hemorrhage,bradycardia and hypotension between the two groups(P>0.05).CRP,IL-6,TNF-α,NSE and S100βin flurbiprofen axetil group were significantly lower than those in fentanyl group at 24 h and 48 h after operation(P<0.05).CONCLUSION:Flurbiprofen exate can reduce the amount of analgesic fentanyl in patients with craniocerebral injury,and has anti-inflammatory effect to reduce brain injury,and can be effectively and safely used in the analgesic management of patients with craniocerebral injury.

关 键 词：氟比洛芬酯 颅脑损伤 镇痛 

分 类 号：R93[医药卫生—生药学] R965.2[医药卫生—药学] R734