儿童扁桃体切除术后两种镇痛方式的比较研究

发布时间：2018-03-26 10:05

本文选题：儿童　切入点：扁桃体切除术　出处：《临床耳鼻咽喉头颈外科杂志》2017年14期

【摘要】：目的:观察儿童扁桃体切除术后种镇痛方式应激疼痛反应的变化。方法:124例儿童扁桃体切除术后的儿童,随机分为A、B两组,分别为60例和64例。手术后A组为使用静脉自控镇痛药物持续静脉输注,B组根据患儿年龄及体重选择小剂量(5mg/kg/次)布洛芬混悬液口服。手术前后24h采用FLACC进行镇痛评分。术前及术后24h均检测血白细胞(WBC)、血清C反应蛋白(CRP)和皮质醇(COR)浓度;检测WBC、CRP和COR浓度行相关性。结果:反应疼痛应激4个指标中,FLACC和COR判断疼痛效能最好,CRP和WBC较差。术后4、24、36h3个时间段,对患儿进行FLACC评分,B与A组同时段相比差异有统计学意义(P0.05),各组组间比较差异没有统计学意义;患儿手术前后A、B组对外周血WBC数目,CRP和COR的浓度变化:A组CRP和COR的浓度手术前后比较差异有统计学意义(P0.05);COR的浓度24hA组与B组比较差异有统计学意义(P0.05)。结论:儿童扁桃体切除术后应激疼痛可以用FLACC评分和测血清COR浓度综合判定,布洛芬混悬液口服可以减小患儿应激疼痛反应,安全满足术后用镇痛需要。
[Abstract]:Objective: to observe the changes of stress pain response after tonsillectomy in children. Methods: 124 children with tonsillectomy were randomly divided into two groups. There were 60 cases and 64 cases of ibuprofen suspension in group A after operation. Group B received continuous intravenous infusion of intravenous controlled analgesic drugs according to the age and weight of the children. Ibuprofen suspension was taken orally at a low dose of 5 mg / kg / time before and 24 hours before and after operation. FLACC was used to treat the patients 24 hours before and after operation. Pain score. WBC, serum C-reactive protein (CRP) and cortisol Corr were measured before and 24 hours after operation. Results: FLACC and COR were the best indexes in judging pain. There was significant difference in FLACC score between group A and group B in the same period (P 0.05), but there was no significant difference between each group. Changes of WBC and COR in peripheral blood of children before and after operation there is a significant difference in the concentration of CRP and COR between group A and group A before and after operation. There is a significant difference between group 24hA and group B in the concentration of CRP and COR. Conclusion: there is a significant difference in the concentration of CRP and COR between group B and group B.Conclusion: there is a significant difference between group A and group B in the concentration of CRP and COR. Stress pain after tonsillectomy can be determined by FLACC score and serum COR concentration. Ibuprofen suspension can reduce the stress pain response and meet the postoperative analgesic needs.
【作者单位】：华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)耳鼻咽喉科;
【分类号】：R766.9

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