氟比洛芬酯在经直肠超声引导前列腺穿刺疼痛控制中的应用

发布时间：2018-01-28 04:53

  本文关键词： 前列腺 穿刺 疼痛 麻醉 氟比洛芬酯　出处：《北京大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的:探索氟比洛芬酯静脉应用能否减轻经直肠超声引导下前列腺穿刺引起的疼痛。方法:采用随机、对照研究方法,共入选81例于北京大学人民医院泌尿外科住院行经直肠超声引导下前列腺穿刺患者,随机分为3组(每组27例),分别是:直肠内局部表面麻醉(intrarectal local anesthesia,IRLA)组:术前5 min 5%(0.05 g/L)利多卡因凝胶60 mg直肠内局部表面麻醉;氟比洛芬酯(flurbiprofen axetil,FA)组:术前1 h氟比洛芬酯静脉滴注(1 mg/kg);IRLA+FA组:术前5 min 5%利多卡因凝胶60 mg直肠内局部表面麻醉,同时术前1 h氟比洛芬酯静脉滴注(1 mg/kg)。使用视觉模拟评分表(visual analogue scale,VAS)评估超声探头插入肛门时(VASⅠ)、麻醉过程中(VASⅡ)、穿刺活检时(VASⅢ)及术后20 min时(VASⅣ)的疼痛评分。使用单因素协方差分析比较3组间患者基线差异。疼痛评分的组间差异采用参数检验的单因素协方差分析。随后采用图基(Tukey)事后检验法进行各组间比较:P1、P2、P3分别为IRLA组和FA组、FA组和IRLA+FA组、IRLA组和IRLA+FA组的组间差异P值,P0.05认为差异有统计学意义,其中组间两两比较采用Bonferroni方法调整检验水准α=0.017。结果:所有患者未见严重的术后并发症。3组患者的基线数据差异无统计学意义,VASⅡ(5.7±2.2,3.0±1.5,3.3±1.9,P=0.012)和VASⅢ(6.7±2.3,3.0±2.1,2.9±1.6,P=0.001)差异有统计学意义;VASⅠ(3.2±1.0,4.1±2.1,4.2±1.7,P=5.752)和VASⅣ(1.4±2.1,1.0±0.9,1.1±0.7,P=3.772)差异无统计学意义。两两组间差异,在VASⅣ(P1=0.007,P2=5.655,P3=0.001)和VASⅢ(P1=0.008,P2=7.517,P3=0.001)方面,IRLA组和FA组、IRLA组和IRLA+FA组的组间差异有统计学意义。结论:氟比洛芬酯能安全、有效地减轻经直肠超声引导下的前列腺穿刺术患者的疼痛。
[Abstract]:Objective: to explore whether the intravenous application of flurbiprofen ester can alleviate the pain caused by transrectal ultrasound guided prostate puncture. A total of 81 patients who underwent transrectal ultrasound guided prostate puncture in urology department of Peking University people's Hospital were randomly divided into 3 groups (27 cases in each group). They were intrarectal local anesthesia. Irla group: 5 min / 5 g / L Lidocaine gel 60 mg intrarectal topical anesthesia before operation; Flurbiprofen axetilFAA group: flurbiprofen flurbiprofen axetilFAA group: 1 mg / kg flurbiprofen intravenously injected flurbiprofen 1 h before operation; IRLA FA group: 5 min 5% lidocaine gel 60 mg intrarectal topical anesthesia. At the same time, 1 mg / kg flurbiprofen ester was injected intravenously 1 h before operation. Visual analogue scale was evaluated by visual analogue scale. Vas) was used to evaluate VAS 鈪，

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