胰十二指肠切除术后不同镇痛药物联合镇痛效果的观察和护理

发布时间：2018-03-30 05:32

本文选题：胰十二指肠切除术　切入点：镇痛方式　出处：《实用医学杂志》2017年02期

【摘要】：目的:观察胰十二指肠切除术(PD)后患者4种不同镇痛药物联合使用的镇痛效果,探究一种更加安全、有效、经济的镇痛方式,分析相关镇痛药物导致的不良反应,有针对性地采取相应护理措施。方法:回顾性选取普外科某手术组的PD术后患者412例,其中男262例,女150例,均采用全身麻醉和自控静脉镇痛(PCIA)方式,依据术后麻醉医生采用的不同镇痛药物组合自然分为4个小组:组1(n=113)地佐辛+凯纷;组2(n=88)地佐辛+舒芬太尼;组3(n=105)诺扬+凯纷;组4(n=106)舒芬太尼+凯纷。采用长海痛尺评价4种不同镇痛药物联合的镇痛效果,并观察术后辅助用药、胃管拔除时间、住院费用、住院时间、不良反应及并发症发生情况。结果:4个小组的患者年龄、性别、体重、手术时间等一般资料差异均无显著性(P0.05)。用长海痛尺评分在术后6 h差异有统计学意义(P0.05):两两比较,组2的评分最低(P0.05);其他时间段的评分差异无统计学意义(P0.05)。术后辅助用药特耐和胃管拔除时间差异有统计学意义(P0.05),两两比较,组2的特耐使用率最低,胃管拔出时间最早。恶心呕吐、瘙痒、腹泻不良反应和术后并发症数比较差异无统计学意义(P0.05),均无尿潴留、呼吸抑制发生。结论:通过临床观察PD术后地佐辛联合舒芬太尼药物联合的镇痛效果更好。通过观察不同镇痛药物的联合使用,及时发现和处理可能出现的不良反应,以便减轻患者的痛苦和促进患者康复。
[Abstract]:Objective: to observe the analgesic effect of combined use of four different analgesic drugs after pancreaticoduodenectomy (PDD), to explore a more safe, effective and economical analgesic method, and to analyze the adverse reactions caused by related analgesic drugs. Methods: 412 PD patients (262 males and 150 females) in a general surgery group were treated with general anesthesia and patient-controlled intravenous analgesia (PCIA). According to the different analgesic drug combinations used by the anesthesiologist after operation, they were divided into four groups: group 1 (n = 113), group 2 (n = 88), group 2) dizosin sufentanil; group 3 (n = 10 5); Group 4 (n = 10 6) sufentanil was used to evaluate the analgesic effect of four different analgesic drugs. The postoperative adjuvant medication, gastric tube extubation time, hospitalization cost and hospitalization time were observed. Results: there was no significant difference in age, sex, body weight, operation time and other general data among the 4 groups. The score of group 2 was the lowest (P 0.05), but the score of other time periods had no significant difference (P 0.05). There was a significant difference in postoperative adjuvant drug resistance and gastric tube extubation time (P 0.05), and the rate of special tolerance in group 2 was the lowest compared with that in group 2. There was no significant difference in the number of postoperative complications, such as nausea and vomiting, itching, diarrhea and postoperative complications. Conclusion: it is better to observe the analgesic effect of dizosin combined with sufentanil after PD. By observing the combined use of different analgesic drugs, we can find and deal with the possible adverse reactions in time. In order to alleviate the pain of patients and promote the recovery of patients.
【作者单位】：中国人民解放军第九二医院精神科;长海医院普外科;
【分类号】：R473.6

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