地佐辛联合芬太尼用于高强度聚焦超声整体消融子宫肌瘤中的临床观察

发布时间：2018-01-20 09:30

本文关键词： 芬太尼妇科学镇痛药地佐辛子宫肿瘤高强度聚焦超声　出处：《重庆医学》2015年02期 　论文类型：期刊论文

【摘要】：目的观察地佐辛与芬太尼联合应用于高强度聚焦超声单次整体消融治疗子宫肌瘤中的可行性。方法将择期进行镇静镇痛下高强度聚焦超声整体消融治疗的子宫肌瘤患者160例随机分为A组(芬太尼+咪达唑仓)80例、B组(联合应用地佐辛+芬太尼+咪达唑仓)80例。用视觉模拟评分法(VAS)评价镇痛效果,监测记录治疗前(T0)、给药时(T1)、治疗开始时(T2)、给药后30min(T3)、治疗结束0h(T4)、治疗结束2h(T5)、治疗结束4h(T6)、治疗结束8h(T7)、治疗结束24h(T8)患者的生命体征变化情况,以及患者的疼痛评分、舒适度评分、镇静评分、镇痛药消耗量、不良反应。结果两组患者治疗中镇痛效果均确切可靠、各时点血压、心率、血氧饱和度、心电图变化均在正常范围内,A组患者的VAS评分及Ramsay评分较B组高,但差异无统计学差异(P0.05);A组患者3例出现排尿困难、对症处理后好转,两组患者均无呼吸抑制反应发生,但B组患者镇痛不良反应发生率明显低于A组,患者满意率显著高于A组(P0.05)。结论地佐辛联合芬太尼在高强度聚焦超声单次整体消融治疗子宫肌瘤中镇痛效果可靠,不良反应少,值得临床中推广使用。
[Abstract]:Objective to observe the feasibility of combination of dizosin and fentanyl in the treatment of uterine leiomyoma by single global ablation with high intensity focused ultrasound (HIFU). 160 cases of tumor patients were randomly divided into group A (. 80 cases of fentanyl midazolam. Group B (80 cases with dizosin fentanyl midazolium) was used to evaluate the analgesic effect with visual analogue score (VASA). At the beginning of treatment, 30 minutes after administration of the drug, T3, T4, T5, T6, T7 and T7 at the end of the treatment were 30 minutes after the treatment and the end of the treatment were 0 h, 2 h, 2 h, 4 h, and 8 h, respectively. Changes in vital signs, pain scores, comfort scores, sedation scores, and analgesics consumption in patients with T8 (24 h after treatment). Results the analgesic effect of the two groups of patients was accurate and reliable. The changes of blood pressure, heart rate, blood oxygen saturation and electrocardiogram were all within the normal range at each time point. The scores of VAS and Ramsay in group A were higher than those in group B, but there was no significant difference (P 0.05). The dysuria occurred in 3 patients in group A and improved after symptomatic treatment. There was no respiratory inhibition in both groups, but the incidence of analgesic adverse reactions in group B was significantly lower than that in group A. Conclusion Dizosin combined with fentanyl in the treatment of uterine leiomyoma with high intensity focused ultrasound has a reliable analgesic effect and few adverse reactions. It is worth popularizing in clinic.
【作者单位】：湖北省妇幼保健院妇科;重庆医科大学生物医学工程学院;
【基金】：国家科技支撑计划资助项目(2011BAI14B01)
【分类号】：R737.33;R614
【正文快照】： 高强度聚焦超声(high intensity focused ultrasound,HI-FU)是近年来兴起的一种非侵入性肿瘤局部消融治疗技术,在子宫肌瘤治疗方面已取得一定成果[1-2]。HIFU采用的镇静镇痛麻醉方式简单易行、不良反应小,促进了该技术在临床上的应用和推广[3]。临床上用于静脉镇痛的药物较多,

【参考文献】