催产素联合瑞芬太尼镇痛泵静脉持续泵入在腹腔镜子宫肌瘤剔除术中的应用  

Application of continuous intravenous infusion of oxytocin combined with remifentanil analgesia pump in laparoscopic myomectomy

作　　者：郭小云 严卫锋 彭文勇[2] Guo Xiaoyun;Yan Weifeng;Peng Wenyong(Department of Anesthesiology,Jinhua City Maternal and Child Health Care Hospital,Jinhua,Zhejiang 321000,China;Department of Anesthesiology,Jinhua City Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市妇幼保健院麻醉科,浙江金华321000 [2]金华市中心医院麻醉科,浙江金华321000

出　　处：《中国药物与临床》2025年第6期398-402,共5页Chinese Remedies & Clinics

基　　金：浙江省金华市重大(重点)科学技术研究计划项目(2021-3-068)。

摘　　要：目的 探讨催产素联合瑞芬太尼镇痛泵静脉持续泵入在腹腔镜子宫肌瘤剔除术中的应用效果。方法 选取2022年1月至2024年1月于浙江省金华市妇幼保健院行腹腔镜子宫肌瘤剔除术100例患者。按照治疗方法分为对照组和观察组,对照组50例患者术后予以镇痛泵静脉持续泵入瑞芬太尼,观察组50例患者予以镇痛泵静脉持续泵入催产素复合瑞芬太尼。使用SPSS 26.0软件进行数据分析,对比2组血流动力学变化、镇痛效果、术后镇痛镇静评分及不良反应情况。结果 静脉镇痛泵连接后观察组30 min(T0)、1h(T1)、12 h(T2)及停用时(T3)时间点心率、平均动脉压较对照组更稳定(t=2.21、2.91、3.11、2.79、1.97、2.17、3.22、3.56,P均<0.05);观察组镇痛效果优良率90.0%高于对照组镇痛效果优良率74.0%(χ^(2)=4.34,P=0.04);术后6 h、术后12 h、术后24 h观察组疼痛视觉模拟评分法(VAS)低于对照组,Ramsay镇静评分高于对照组(t=5.06 、11.55、1.56、7.80、8.87、7.67,P均<0.05);2组不良反应发生率比较差异无统计学意义(χ^(2)=0.543,P=0.46)。结论 腹腔镜子宫肌瘤剔除术中将催产素以及瑞芬太尼以镇痛泵静脉持续泵入的方式应用后,能够获取良好的镇痛与镇静成效,安全性良好。Objective To explore the application effect of continuous intravenous infusion of oxytocin combined with remifentanil via an analgesia pump in laparoscopic myomectomy.Methods A total of 100 patients undergoing laparoscopic myomectomy in Jinhua Maternal and Child Health Hospital from January 2022 to January 2024 were included in the study.According to the treatment methods,they were divided into a control group(n=50)and an the observation group(n=50).The control group received continuous intravenous infusion of remifentanil via an analgesic pump,while the observation group received continuous intravenous infusion of oxy-tocin combined with remifentanil via an analgesic pump.SPSS 26.0 software was used for data analysis.The hemodynamic changes,analgesic effects,postoperative analgesia and sedation scores,and adverse reactions of the two groups were compared.Results After intravenous analgesia pump was connected,the heart rate and mean arterial pressure in the observation group were more stable than those in the control group at 30 min(T0),1 h(T1),12 h(T2)and at the time point of disuse(T3)(t=2.21,2.91,3.11,2.79,1.97,2.17,3.22,3.56,all P<0.05).The analgesic effect was significantly higher in the observation group(90.0%)than that in the control group(74.0%)(χ^(2)=4.34,P=0.04).The pain visual analogue scale(VAS)in the observation group was lower than that in the control group at 6 h,12 h and 24 h after surgery,and Ramsay sedation score was higher than that in the control group(t=5.06,11.55,1.56,7.80,8.87,7.67;all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.543,P=0.46).Conclusion After continuous intravenous infu-sion of oxytocin and remifentanil through an analgesic pump during laparoscopic myomectomy,good analgesic and sedative effects can be achieved with low incidence of adverse reactions and high safety.

关 键 词：腹腔镜子宫肌瘤剔除术 催产素 瑞芬太尼 镇痛泵 静脉持续泵入 

分 类 号：R61[医药卫生—外科学]