对乙酰氨基酚联合不同种类阿片类药物用于急诊创伤性骨折患者的镇痛效果  

Analgesic effect of acetaminophen combined with different kinds of opioids in patients with emergency traumatic fracture

作　　者：杜天天[1] 郑文婷 朱军[1] 王立伟[2,3] 刘浩 滕井卫 丁玉雪 戚钰 DU Tiantian;ZHENG Wenting;ZHU Jun;WANG Liwei;LIU Hao;TENG Jingwei;DING Yuxue;QI Yu(Department of Emergency Medicine,Xuzhou Central Hospital,Xuzhou 221009,CHINA)

机构地区：[1]徐州市中心医院急诊科,江苏221009 [2]徐州市中心医院麻醉科,江苏221009 [3]徐州医科大学徐州临床学院

出　　处：《江苏医药》2024年第11期1099-1102,共4页Jiangsu Medical Journal

基　　金：徐州市科技创新重点研发计划项目(KC21251)。

摘　　要：目的 观察对乙酰氨基酚联合不同种类阿片类药物用于急诊创伤性骨折患者的镇痛效果。方法 329例急诊创伤性骨折患者随机分为两组。A组161例,采用对乙酰氨基酚联合盐酸曲马多镇痛;B组168例,采用对乙酰氨基酚联合盐酸羟考酮镇痛。比较两组用药前(T0)、用药后30min(T1)、2h(T2)、1d(T3)、2d(T4)和3d(T5)时数字评定量表(NRS)疼痛评分。记录两组3d内不良反应发生及安眠类药物使用情况。结果 两组间各时间点NRS疾痛评分比较无统计学差异(P>0.05)。两组T1~T5时NRS疼痛评分均低于T0时(P<0.05),且T1~T3时的NRS疼痛评分逐步降低(P<0.05)。两组安眠类药物使用率无统计学差异(P>0.05)。B组恶心呕吐、头晕、嗜睡和便秘发生率高于A组(P<0.05)。结论 对乙酰氨基酚联合盐酸曲马多或盐酸羟考酮用于创伤性骨折患者急性疼痛的镇痛效果相仿,但后者的不良反应较多。Objective To observe the analgesic effect of acetaminophen combined with different kinds of opioids in the patients with emergency traumatic fracture.Methods A total of 329 patients with emergency traumatic fracture were randomly divided into two groups.Analgesia was performed with acetaminophen combined with tramadol hydrochloride in group A(161 cases)and with acetaminophen combined with oxycodone hydrochloride in group B(168 cases).The incidence of adverse reactions and the use of sleeping drugs within 3 days were compared between the two groups.The numerical rating scale(NRS)pain scores of two groups were compared at the time points of before analgesia(T0)and 30 minutes(T1),2 hours(T2),1 day(T2),2 days(T3)and 3 days(T4)after medication.Results There were no significant differences in NRS pain scores between the two groups at each time point(P>0.05).The NRS pain scores of two groups were lower at T1-T5 than those at TO(P<0.05),which were decreased gradually from T1 to T3(P<0.05).There was no significant difference in the usage rate of sleeping drugs between the two groups(P>0.05).The incidences of nausea and vomiting,dizziness,drowsiness and constipation were higher in group B than those in group A(P<0.05).Conclusion For analgesia in the patients with emergency traumatic fracture,the analgesic effect of acetaminophen combined with tramadol hydrochloride is similar to that of acetaminophen combined with oxycodone hydrochloride,but the latter has more adverse reactions.

关 键 词：对乙酰氨基酚 阿片类药物 创伤性骨折 镇痛 

分 类 号：R614[医药卫生—麻醉学]