地佐辛联合氟比洛芬酯在老年股骨粗隆间骨折术后自控镇痛中的应用  

Application of Dezocine Combined with Flurbiprofen in Controlled Analgesia after Operation of Intertrochanteric Fracture of Femur in Elderly Patients

作　　者：张思甜 杨进辉 罗文忠 Zhang Sitian(Guangzhou Osteopathic Hospital,Guangzhou 510000)

机构地区：[1]广州市正骨医院,广东广州510000 [2]佛山市中医院,广东佛山528000

出　　处：《黑龙江医药》2024年第6期1293-1296,共4页Heilongjiang Medicine journal

基　　金：广东省中医药局科研项目(项目编号:20241311)。

摘　　要：目的:探究地佐辛联合氟比洛芬酯在老年股骨粗隆间骨折术后自控镇痛中的应用价值。方法:从广州市正骨医院收集2022年6月—2024年6月进行骨折手术的92例老年股骨粗隆间骨折患者,依据术后镇痛方案不同分为两组,观察组(n=46)与参照组(n=46)。均接受闭合复位微创股骨近端防旋髓内钉治疗,参照组术后自控镇痛予以氟比洛芬酯,观察组术后自控镇痛予以地佐辛联合氟比洛芬酯。比较两组术后不同时间点心率(HR)及平均动脉压(MAP)、疼痛VAS评分、认知功能MMSE评分;比较两组术后不良反应情况。结果:观察组术后1h、4h、8h及24h的HR、MAP及VAS评分较参照组低(P<0.05);两组术前、术后12h、24h及48h的MMSE评分组间比较,无统计学差异(P>0.05);观察组与参照组术后不良反应发生率分别率为8.70%、13.04%,比较无统计学差异(P>0.05)。结论:地佐辛与氟比洛芬酯的术后联合镇痛方案应用于老年股骨粗隆间骨折患者的术后自控镇痛,效果显著,且利于平衡心率及平均动脉压,不会对术后认知功能造成影响,亦不会增加不良反应,值得推广研究。Objective:To explore the clinical value of dezocine combined with flurbiprofen axidate in patients with intertrochanteric fracture of femur after controlled analgesia.Methods:92 elderly patients with intertrochanteric femoral fracture who underwent fracture surgery from June 2022 to June 2024 were collected from Guangzhou Osteopathic Hospital and divided into two groups according to different postoperative analgesia protocols,observation group(n=46)and reference group(n=46).All patients were treated with closed reduction minimally invasive proximal femur anti-rotatory intramedullary nailment.The reference group was given flurbiprofen ester for controlled postoperative analgesia,and the observation group was given dezocine combined with flurbiprofen ester for controlled postoperative analgesia.Heart rate(HR),mean arterial pressure(MAP),pain VAS score and cognitive function MMSE score were compared between the two groups at different time points.Postoperative adverse reactions were compared between the two groups.Results:HR,MAP and VAS scores of observation group at 1h,4h,8h and 24h after operation were lower than those of reference group(P<0.05).There was no significant difference in MMSE scores between the two groups before operation,12h,24h and 48h after operation(P>0.05).The incidence of postoperative adverse reactions was 8.70%and 13.04%in the observation group and the reference group,respectively,with no statistical difference(P>0.05).Conclusion:The combined postoperative analgesia regimen of dezocine and flurbiprofen axetil in elderly patients with intertrochanteric fracture has a significant effect on postoperative self-controlled analgesia,and is beneficial to balance heart rate and mean arterial pressure,and does not affect postoperative cognitive function or increase adverse reactions,which is worthy of promotion and research.

关 键 词：股骨粗隆间骨折 老年 术后镇痛 地佐辛 氟比洛芬酯 

分 类 号：R683.4[医药卫生—骨科学]