氢吗啡酮对老年结肠癌根治术患者术后镇痛效果及认知功能的影响分析  

Analysis of the Effects of Hydromorphone on Postoperative Analgesia and Cognitive Function in Elderly Patients Undergoing Radical Resection of Colon Cancer

作　　者：么继钢 朱芳 YAO Jigang;ZHU Fang(Department of Anesthesiology,Jiawang District People's Hospital of Xuzhou City,Xuzhou,Jiangsu,221011,China)

机构地区：[1]徐州市贾汪区人民医院麻醉科,江苏徐州221011

出　　处：《中外医疗》2024年第33期60-63,共4页China & Foreign Medical Treatment

摘　　要：目的 将氢吗啡酮应用于老年结肠癌根治术的术后镇痛中,并对该药物的应用效果进行分析。方法方便选取2022年1月—2023年12月徐州市贾汪区人民医院普外科接受根治手术治疗的102例老年结肠癌患者为研究对象,根据镇痛用药的不同分为研究组(给予氢吗啡酮)和对照组(给予患者舒芬太尼作为术后静脉自控镇痛主要药物),各51例。对比两组患者的镇痛效果、认知功能、不良反应发生情况。结果 镇痛后,研究组术后48 h和术后72 h的数字评分量表评分分别为(1.65±0.61)分、(1.01±0.42)分,均低于对照组的(2.31±0.53)分与(2.12±0.11)分,差异有统计学意义(t=5.833,18.258;P均<0.05)。镇痛前,两组患者术前1 h的神经元特异性烯醇化酶(neuron-spacific enolase,NSE)与中枢神经特异蛋白(S100 protein,S-100β)指标对比,差异无统计学意义(P均>0.05)。镇痛后,研究组术后72 h的NSE与S-100β指标分别为(7.22±0.52)μg/L与(88.75±7.26)pg/mL,均低于对照组的(9.51±0.62)μg/L与(109.22±8.22)pg/mL,差异有统计学意义(t=20.210,13.329;P均<0.05)。研究组的不良反应发生率为1.96%(1/51),低于对照组的17.65%(9/51),差异有统计学意义(χ^(2)=7.096,P=0.008)。结论 在老年结肠癌根治术患者的术后静脉自控镇痛中应用氢吗啡酮能够有效减轻患者的术后疼痛程度,镇痛效果良好,同时能够降低对患者术后认知障碍的影响,不良反应的发生率较低。Objective To apply hydromorphone in postoperative analgesia for elderly patients undergoing radical resection of colon cancer and analyze the application effect of this drug.Methods A total of 102 elderly colon cancer patients who received radical surgery in the general surgery Department of Jiawang District People's Hospital of Xuzhou City from January 2022 to December 2023 were conveniently selected as the research objects.According to different analgesic drugs,they were divided into a study group(given hydromorphone) and a control group(given sufentanil as the main drug for postoperative patient-controlled intravenous analgesia),with 51 cases in each group.The analgesic effect,cognitive function,and occurrence of adverse reactions were compared between the two groups.Results After analgesia,the Numerical Rating Scale scores of the study group at 48 h and 72 h after surgery were(1.65±0.61) points and(1.01±0.42) points,which were lower than those of the control group(2.31±0.53) points and(2.12±0.11) points,and the differences were statistically significant(t=5.833,18.258;both P<0.05).Before analgesia,there were no statistically significant differences in the neuron-specific enolase(NSE) and S100β protein(S-100β) indexes of the two groups of patients 1 h before surgery(both P>0.05).After analgesia,the NSE and S-100β indexes of the study group at 72 h after surgery were(7.22±0.52) μg/L and(88.75±7.26) pg/mL,which were lower than those of the control group(9.51±0.62) μg/L and(109.22±8.22) pg/mL,and the differences were statistically significant(t=20.210,13.329;both P<0.05).The incidence of adverse reactions in the study group was 1.96%(1/51),which was lower than 17.65%(9/51) in the control group,and the difference was statistically significant(χ^(2)=7.096,P=0.008).Conclusion The application of hydromorphone in postoperative patient-controlled intravenous analgesia for elderly patients after radical resection of colon cancer can effectively reduce the postoperative pain degree of patients,has a good an

关 键 词：氢吗啡酮 老年结肠癌根治术 术后静脉自控镇痛 认知功能 

分 类 号：R614[医药卫生—麻醉学]