直肠癌患者术后止痛效果与吻合口功能不全的相关性

发布时间：2018-01-22 14:33

本文关键词： 直肠癌术后疼痛吻合口舒芬太尼　出处：《中国老年学杂志》2015年10期 　论文类型：期刊论文

【摘要】：目的探讨直肠癌患者术后服用阿片类及非阿片类止痛药后止痛效果与吻合口功能不全的相关性。方法 97例直肠癌切除术后患者按照对舒芬太尼止痛敏感程度,分为阿片类止痛药有反应组和无反应组,观察两组术后疼痛强度、药物使用量、术后恶心呕吐的发生率、首次排便时间、住院天数,吻合口功能状况。结果无反应组与有反应组年龄、体重指数、性别、手术时间、美国麻醉师协会(ASA)评分均无统计学差异(P0.05)。无反应组初始疼痛、术后6、12、24和48 h的疼痛强度,二线止痛药及非阿片类药物的使用量均高于有反应组(P0.05)。两组术后恶心呕吐的发生率、首次排便时间、住院天数均无统计学差异(P0.05)。术后吻合口功能不全者共12例(12.4%),有反应组3例,无反应组9例,两组吻合口功能不全情况有显著差异(χ2=4.85;P0.05)。结论对阿片类止痛药物无反应及二线止痛药使用量大是直肠癌患者术后吻合口功能不全的危险因素。
[Abstract]:Objective to investigate the relationship between postoperative analgesic effect and anastomotic dysfunction in patients with rectal cancer. 97 patients with rectal cancer after resection according to the sensitivity of sufentanil. The pain intensity, drug usage, postoperative nausea and vomiting rate, first defecation time and hospital stay were observed in the two groups. Results the age, body mass index (BMI), sex and operation time of the non-reaction group and the response group were analyzed. There was no significant difference in ASAs score between the two groups (P 0.05). The initial pain was found in the non-response group, and the pain intensity at 612h and 48h postoperatively. The use of second-line painkillers and non-opiates was higher than that of the response group (P 0.05). The incidence of nausea and vomiting and the time of first defecation in the two groups were higher than those in the control group. There was no significant difference in the number of days in hospital (P 0.05). There were 12 cases with postoperative anastomotic insufficiency, 3 cases in the response group and 9 cases in the non-reaction group. There was a significant difference in anastomotic dysfunction between the two groups (蠂 2 = 4.85). Conclusion No reaction to opioid analgesic drugs and large use of second-line analgesic drugs are the risk factors for postoperative anastomotic dysfunction in patients with rectal cancer.
【作者单位】：佳木斯市中心医院;佳木斯大学附属第一医院;
【基金】：黑龙江省自然科学基金项目(H201359) 黑龙江省卫生厅项目(2013235) 佳木斯大学校级青年基金项目(Sq2013-022)
【分类号】：R735.37
【正文快照】： 直肠癌患者术后疼痛常见,可能是由于外科手术过程中局部组织损伤,导致前列腺素、组胺、缓激肽等炎症介质释放〔1〕。缓解术后疼痛能够减少直肠癌术后并发症的发生率并缩短患者住院日。直肠癌术后止痛普遍采用单独或联合使用阿片类止痛药及非阿片类止痛药。阿片类止痛药常见的

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