| 张 振,王 君,张 茹,卫白杨,王 瑗.腹腔镜胃癌根治术后镇痛中地佐辛应用的有效性及对患者血流动力学的影响[J].,2021,(12):2298-2302 |
| 腹腔镜胃癌根治术后镇痛中地佐辛应用的有效性及对患者血流动力学的影响 |
| Efficacy of Dextrozine in Analgesia after Laparoscopic Radical Gastrectomy and Its Effect on Hemodynamics |
| 投稿时间：2020-11-28 修订日期：2020-12-23 |
| DOI：10.13241/j.cnki.pmb.2021.12.022 |
| 中文关键词: 腹腔镜胃癌根治术 术后镇痛 地佐辛 布托菲诺 血流动力学 炎症反应 |
| 英文关键词: Laparoscopic radical gastrectomy Postoperative analgesia dizocine Buttofino Hemodynamics Inflammatory response |
| 基金项目:陕西省自然科学基础研究计划项目（2020JQ-950） |
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| 中文摘要: |
| 摘要 目的：探讨腹腔镜胃癌根治术后镇痛中地佐辛应用的有效性及对患者血流动力学的影响。方法：选取2018年10月~2019年5月我院收治的需接受腹腔镜下胃癌根治术治疗患者120例，按照数字表法将其随机分为两组，对照组应用布托菲诺进行术后镇痛，研究组应用布托菲诺联合地佐辛进行术后镇痛，分析两组患者镇痛效果、炎症反应以及术后血流动力学改变情况，对比两组患者镇痛安全性。结果：研究组术后24 h、48 h疼痛视觉模拟评分（VisualAnalogueScale/Score，VAS）评分评分低于对照组（P＜0.05），研究组术后6 h、12 h布氏舒适评分（Brinell Comfort Score，BCS）评分低于对照组（P＜0.05）；研究组术后24 h、48 h的白细胞介素-6（interleukin-6，IL-6）低于对照组（P＜0.05），研究组术后24 h、48 h 的IL-2高于对照组（P＜0.05）；研究组术后6 h、12 h、24 h的简易精神状态量表（MMSE）评分高于对照组（P＜0.05），研究组术前以及术后48 h与对照组无明显差异（P＞0.05）；研究组舒张压（diastolic blood pressure，DBP）、收缩压（systolic blood pressure ，SBP）以及心率（heart rate，HR）水平在麻醉前、气管拔管后5 min以及10 min时变化无明显差异（P＞0.05），对照组HR、SBP以及DBP水平在气管拔管后5 min以及10 min时高于麻醉前（P＜0.05），研究组气管拔管后5 min以及10 min时HR、SBP以及DBP水平低于对照组（P＜0.05）；研究组不良反应低于对照组（P＜0.05）。结论：在对腹腔镜胃癌根治术患者术后进行镇痛干预时，在布托菲诺的基础上联合使用地佐辛可有效降低对患者血流动力学的影响，提高镇痛效果，降低患者应激反应，且具有较高的安全性。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effectiveness of dextrozine in analgesia after laparoscopic radical gastrectomy and its effect on hemodynamics. Methods: A total of 120 patients, who underwent laparoscopic radical gastrectomy in Air Force Military Medical University of Tangdu Hospital from October 2018 to May 2019, were selected and randomly divided into two groups according to the digital table method. The control group was treated with buttofin for postoperative analgesia, and the study group, with bufino and dextrozine for postoperative analgesia. The analgesic effect, inflammatory response and postoperative hemodynamic changes of the two groups were analysed of; The safety of analgesia between the two groups was compared. Results: The VAS（VisualAnalogueScale/Score, VAS） scores of the study group were lower than those of the control group at 24 h and 48 h after operation (P<0.05). The BCS（Brinell Comfort Score, BCS） scores of the study group were lower than those of the control group at 6 h and 12 h after operation(P<0.05). The study group received IL-6 at 24 h and 48 h after operation. Compared with the control group(P<0.05), the IL-2 level of the study group was higher than that of the control group at 24 h and 48 h after operation(P<0.05). The MMSE score of the study group was higher than that of the control group at 6 h, 12 h and 24 h after operation (P<0.05). There was no significant difference before operation and 48 h after operation between the study group and the control group(P>0.05). There was no significant difference in the HR, SBP and DBP levels in the study group before the anesthesia and 5 minutes and 10 minutes after the tracheal extubation(P>0.05). The levels of HR, SBP and DBP in the control group were higher than those before anesthesia at 5 min and 10 min after tracheal extubation(P<0.05). The levels of HR, SBP and DBP in the study group were lower than those in the control group 5 min and 10 min after tracheal extubation(P<0.05); the adverse reactions of the study group were lower than those in the control group(P<0.05). Conclusion: In the postoperative analgesia intervention for patients undergoing laparoscopic radical gastrectomy, the combination of dizocine on the basis of buttofino can effectively reduce the hemodynamic effect on patients, improve the analgesic effect, and reduce the patient's response, with high safety. |
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