塞来昔布超前镇痛在腹股沟疝修补术中的临床效果

发布时间：2018-04-25 09:13

本文选题：超前镇痛 + 塞来昔布　；参考：《青岛大学》2017年硕士论文

【摘要】：目的观察塞来昔布超前镇痛用于腹股沟疝无张力修补术的效果,评估其在腹股沟疝无张力修补术应用中的有效性和安全性。方法(1)收集青岛市中心医院疝和腹壁外科自2016年1月-12月100例择期行单侧腹股沟疝无张力修补术的男性患者,将其随机分为治疗组(A组)和对照组(B组),每组各50例,治疗组于术前24h和12h分别口服塞来昔布200mg,术后不用药,对照组术前、术后均不用药。治疗组和对照组两组患者均行腹股沟疝无张力修补术,而且都使用同等剂量的利多卡因注射液进行局部浸润麻醉来完成手术。(2)两组患者均于术后2、4、8、12采用视觉模拟评分(VAS)和最高VAS评分对患者疼痛程度进行疼痛分级评分。(3)对比两组患者的术后各项指标,其包括术后使用补救性镇痛药物曲马多的例数、术后的各类不良反应,平均的术后住院时长,患者手术结束时及术后24h分别抽取外周血2m L,测定外周血Hs-CRP水平。结果(1)治疗组患者术后2、4、8、12 h的VAS评分及术后最高VAS评分均低于对照组,差异有统计学意义(P0.05);(2)术后治疗组和对照组分别有3例和11例患者使用曲马多,差异有统计学意义(χ2=5.175,P=0.023);治疗组和对照组患者术后分别有2例和8例患者发生不良反应,差异有统计学意义(χ2=3.927,P=0.048);治疗组术后住院时间短于对照组(P0.05);(3)分别统计两组患者手术结束时及术后24h外周血超敏C-反应蛋白(Hs-CRP)的水平,结果证实治疗组Hs-CRP水平明显低于对照组,差异有统计学意义(P0.05)。结论塞来昔布作为目前临床上常用的超前镇痛药物,其术后镇痛效果确切,患者满意度较高,不良反应明显减少,有利于患者早日康复,可以广泛的应用于腹股沟疝无张力修补术。
[Abstract]:Objective to evaluate the efficacy and safety of celecoxib preemptive analgesia in the tension-free repair of inguinal hernia. Methods from January to December 2016, 100 male patients with unilateral inguinal hernia tension-free repair were randomly divided into treatment group A (n = 50) and control group B (n = 50). Celecoxib 200 mg was taken orally at 24 hours and 12 hours before operation in the treatment group and no drug was given before and after operation in the control group. Tension-free repair of inguinal hernia was performed in both the treatment group and the control group. Both groups were treated with the same dose of lidocaine injection for local infiltration anesthesia to complete the operation.) both groups were assessed with visual analogue score (VASS) and maximum VAS score for the pain degree. (3) comparing the postoperative indexes between the two groups, It included the cases of tramadol, the adverse reactions after operation, the average length of stay in hospital after operation, and the level of Hs-CRP in peripheral blood taken from the patients at the end of operation and 24 hours after operation, respectively. Results 1) the VAS scores and the highest VAS scores in the treatment group were significantly lower than those in the control group at 12 h after operation (P 0.05). There were 3 cases in the treatment group and 11 cases in the control group, and tramadol was used in the treatment group and the control group, respectively. The difference was statistically significant (蠂 ~ 2 = 5.175), the adverse reactions occurred in 2 cases and 8 cases in the treatment group and the control group, respectively. The difference was statistically significant (蠂 ~ 2 / 3.927 / P ~ (0.048)). The postoperative hospitalization time of the treatment group was shorter than that of the control group (P _ (0.05)). The levels of Hs-CRP in peripheral blood of the two groups were calculated at the end of operation and 24 hours after operation. The results showed that the level of Hs-CRP in the treatment group was significantly lower than that in the control group. The difference was statistically significant (P 0.05). Conclusion Celecoxib is a commonly used preemptive analgesic drug in clinical practice at present. The postoperative analgesia effect of celecoxib is accurate, the patient satisfaction is higher, and the adverse reaction is obviously reduced, which is beneficial to the early recovery of the patients. It can be widely used in inguinal hernia tension-free repair.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614

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