| 戴 云,李富强,卢爱平,霍东燚,何宝通,陈小雄.罗哌卡因切口浸润联合静脉自控镇痛对肝癌肝切除术患者术后镇痛镇静效果及肝功能的影响[J].,2021,(7):1301-1304 |
| 罗哌卡因切口浸润联合静脉自控镇痛对肝癌肝切除术患者术后镇痛镇静效果及肝功能的影响 |
| Effects of Ropivacaine Incision Infiltration Combined with Patient-controlled Intravenous Analgesia on Postoperative Analgesia and Sedation and Liver Function in Patients with Liver Cancer Undergoing Hepatectomy |
| 投稿时间：2020-08-22 修订日期：2020-09-18 |
| DOI：10.13241/j.cnki.pmb.2021.07.022 |
| 中文关键词: 罗哌卡因 切口浸润 静脉自控镇痛 肝切除术 镇痛 镇静 肝功能 |
| 英文关键词: Ropivacaine Incision infiltration Patient-controlled intravenous analgesia Hepatectomy Analgesia Sedation Liver function |
| 基金项目:国家自然科学基金青年基金项目（81602937）；北京市科技计划项目（Z1611000115161093） |
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| 中文摘要: |
| 摘要 目的：探讨静脉自控镇痛（PCIA）联合罗哌卡因切口浸润对肝癌肝切除术患者术后的镇痛镇静效果及肝功能的影响。方法：选取2017年2月~2019年4月期间我院收治的119例行肝切除术的肝癌患者，根据随机数字表法分为对照组（n=59）和研究组（n=60），对照组患者术后给予生理盐水联合 PCIA，研究组患者术后给予罗哌卡因切口浸润联合PCIA。比较两组患者术后指标、镇痛镇静效果、肝功能及不良反应。结果：研究组腹腔引流管拔出时间、术后首次下床活动时间、术后住院时间较对照组更短（P<0.05），术后 PCIA 药物使用量少于对照组（P<0.05）。两组患者术后4 h~术后48 h视觉模拟疼痛评分量表（VAS）评分均呈先升高后降低趋势，且术后12 h、术后24 h、术后48 h研究组VAS评分均低于对照组（P<0.05）；研究组术后12 h、术后24 h、术后48 h Ramsay镇静评分均高于对照组（P<0.05）。两组患者术后3 d丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)水平均升高（P<0.05）。两组患者不良反应发生率比较无统计学差异（P>0.05）。结论：罗哌卡因切口浸润联合PCIA应用于肝癌肝切除术患者术后镇痛，镇静镇痛效果确切，可有效改善术后指标，且不增加肝功能损害，不良反应发生率较低。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of ropivacaine incision infiltration combined with patient-controlled intravenous analgesia (PCIA) on postoperative analgesia and sedation and liver function in patients with liver cancer undergoing hepatectomy. Methods: 119 patients with liver cancer who underwent hepatectomy in our hospital from February 2017 to April 2019 were selected, they were divided into control group (n=59) and study group (n=60) according to the random number table. The patients in the control group were given normal saline combined with PCIA, and the patients in the study group were given ropivacaine incision infiltration combined with PCIA. The postoperative indexes, analgesic and sedative effects, liver function and adverse reactions were compared between the two groups. Results: The first time of getting out of bed, the time of pulling out abdominal drainage tube and the time of hospitalization in the study group were shorter than those in the control group (P<0.05), and the amount of PCIA drug used was less than that in the control group (P<0.05). The visual analogue pain (VAS) scores in the two groups increased first and then decreased at 4 h after operation~48 h after operation, and the VAS scores in the study group was lower than that in the control group at 12 h after operation, 24 h after operation and 48h after operation (P<0.05). The Ramsay Sedation scores in the study group were higher than those in the control group at 12 h after operation, 24 h after operation (P<0.05). Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) were all increased in the two groups at 3 days after operation (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Ropivacaine incision infiltration combined with PCIA can be used for postoperative analgesia in patients with liver cancer hepatectomy, the effect of sedation and analgesia is accurate, and it can effectively improve the postoperative indexes without increasing the damage of liver function, and the incidence of adverse reactions is low. |
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