不同剂量地佐辛对全麻手术病人术后尿管引起膀胱刺激症的干预效果

发布时间：2018-04-02 02:20

本文选题：全麻　切入点：尿管相关膀胱刺激症　出处：《山西医科大学》2014年硕士论文

【摘要】：目的评估不同剂量地佐辛对全麻恢复期尿管相关膀胱刺激症（catheter-related bladder discomfort，CRBD）的治疗效果。方法择期全麻下行后路椎体间植骨融合术男性患者,ASAⅠ或Ⅱ级,年龄40～65岁,体重指数在18～25之间,选择送达麻醉恢复室（post anesthesia careunit，PACU）后主诉CRBD患者100例，采用随机数字表法,将患者分为四组（n=25），对照组（C组）静脉注射生理盐水2ml，不同剂量地佐辛组（D1～3组）分别静脉注射地佐辛5mg、7.5mg、10mg。分别于用药后即刻(T0)、1h(T1)、2h(T2)和6h(T3)，评估病人CRBD的程度和镇静程度，记录手术时间、术中舒芬太尼用量、PACU芬太尼用量以及不良反应发生情况。结果 1.CRBD程度的比较 T0时刻，四组间CRBD程度比较差异无统计学意义（P0.05），T1、T2、T3时刻，C组CRBD程度[（轻度8例、中度15例、重度2例）、（无症状患者1例、轻度12例、中度11例、重度1例）、（无症状患者3例、轻度14例、中度7例、重度1例）]与D1组[（轻度15例、中度9例、重度1例）、（无症状患者7例、轻度14例、中度4例）、（无症状患者10例、轻度14例、中度1例）]、D2组[（无症状者1例、轻度17例、中度6例、重度1例）、（无症状患者13例、轻度10例、中度2例）、（无症状患者14例、轻度10例、中度1例）]、D3组[（无症状患者1例、轻度17例、中度7例）、（无症状者12例、轻度12例、中度1例）、（无症状患者15例、轻度9例、中度1例）]比较，差异有统计学意义（P0.05），D1组CRBD程度与D2组、D3组比较，差异有统计学意义（P0.05）；而D2组和D3组比较差异无统计学意义（P0.05）。 2．镇静程度的比较 T0，T3时刻,四组间镇静程度比较差异无统计学意义（P0.05）；T1、T2时刻，C组镇静程度[（无症状患者23例、轻度2例）、（无症状者25例）]与D1组[（无症状患者10例、轻度15例）、（无症状患者7例、轻度18例）]、D2组[（无症状患者2例、轻度21例、中度2例）、（无症状患者3例、轻度22例）]、D3组[（无症状患者1例、轻度21例、中度3例）、（无症状患者2例、轻度22例、中度1例）]比较，，差异有统计学意义（P0.05），而D2组和D3组比较差异无统计学差异（P0.05）。 3.四组间呼吸抑制和恶心呕吐发生情况的比较四组患者均未见呼吸抑制；四组间术后恶心呕吐发生率比较，差异无统计学差异（P0.05）。结论地佐辛可以缓解CRBD，其适宜剂量为7.5mg。
[Abstract]:Objective To evaluate the therapeutic effect of different doses of zoxin on urinary tract related bladder discomfort ( CRBD ) in patients with general anesthesia .

Methods 100 patients with CRBD were randomly divided into four groups ( n = 25 ) and control group ( group C ) . The patients were divided into four groups ( n = 25 ) . The patients were divided into four groups ( n = 25 ) .

Results

1 . Comparison of the extent of CRBD

At the time of T0 , there was no significant difference between the four groups ( P0.05 ) , T1 , T2 , T3 , the degree of CRBD in group C ( mild in 8 cases , moderate in 15 cases , severe in 2 cases ) , ( asymptomatic patient in 1 case , mild 14 cases , moderate in 1 case ) , ( asymptomatic patient in 1 case , mild in 10 cases , moderate in 1 case ) , ( asymptomatic patient 14 cases , mild 10 cases , moderate 1 case ) , D3 group ( 1 case without symptoms ) , There was significant difference in the degree of CRBD in D1 group compared with that in D2 group and D3 group ( P0.05 ) .
There was no significant difference between D2 group and D3 group ( P0.05 ) .

2 . Comparison of sedation levels

There was no significant difference between the four groups ( P0.05 ) .
There was no significant difference between D2 and D3 groups ( P0.05 ) .

3 . Comparison of the occurrence of respiratory depression and nausea and vomiting among the four groups

No respiratory depression was found in all four groups .
There was no significant difference in the incidence of nausea and vomiting between the four groups ( P0.05 ) .

Conclusion The optimal dosage is 7.5 mg , which can alleviate the CRBD .

【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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