特异性COX-2抑制剂在肝癌肝切除术患者ERAS中的临床应用

发布时间：2019-07-08 14:52

【摘要】：目的:探讨特异性COX-2抑制剂在肝癌肝切除术后患者ERAS理念中的镇痛效果。方法:选择吉林大学第一医院于2015年4月—2015年12月期间收治的90例肝癌肝切除术患者。严格按照入组标准及排除标准,随机分为实验组、对照组,其中实验组50例,对照组40例。对照组术后72小时内每12小时给予肌内注射生理盐水2ml,试验组在术后72小时内每12小时给予肌内注射特异性COX-2抑制剂。用统计学方法记录比较二组病人的术中资料,术后首次肛门排气时间,术后首次下床时间,术后住院费用,术后住院时间,术后72h加用阿片类药物镇痛次数,术后3天疼痛评分,术后并发症、不良反应等。结果:与对照组相比,实验组患者的术后首次肛门排气时间、术后首次下床时间、术后住院时间明显缩短,术后住院费用降低,术后72小时加用阿片类药物次数减少,术后3天的疼痛评分降低,术后发生胸水例数、恶心呕吐、呼吸抑制例数均减少,差异有统计学意义(均P0.05)。结论:肝癌肝切除术患者术后早期使用特异性COX-2抑制剂安全、有效,能显著缓解患者肝癌肝切除术后的疼痛程度,促进患者术后的恢复,减少住院时间、住院费用及术后阿片类药物的用量,是肝癌肝切除术后患者镇痛的良好选择。
[Abstract]:Objective: To study the analgesic effect of specific COX-2 inhibitor in the post-hepatectomy of patients with liver cancer. Methods:90 patients with hepatic resection of liver cancer were selected from the first hospital in Jilin University from April 2015 to December 2015. The experimental group and the control group were randomly divided into the experimental group and the control group according to the criteria of the inclusion and the exclusion criteria. Intramuscular injection of 2 ml of saline was administered intramuscularly every 12 hours after 72 hours after the control group, and the test group was given an intramuscular injection specific COX-2 inhibitor every 12 hours after 72 hours of operation. The operative data of the two groups of patients were recorded by the statistical method. The first time after the operation, the first time after operation, the post-operative hospitalization, the postoperative hospital stay, the number of opioid analgesic after 72 hours after operation, the postoperative 3-day pain score, the postoperative complications, the adverse reaction, etc. Results: Compared with the control group, the first time after the operation of the experimental group, the first time after the operation, the time of the hospital stay was significantly shortened, the hospital cost was reduced, the number of opioid drugs was decreased in 72 hours after operation, and the pain score of 3 days after operation was reduced. The number of pleural effusion, nausea and vomiting and the number of respiratory depression were reduced after operation, and the difference was statistically significant (P <0.05). Conclusion: The use of specific COX-2 inhibitor is safe and effective in the early stage of the patients with liver cancer, and can obviously relieve the pain degree after the liver resection of the liver cancer of the patient, promote the recovery after the operation of the patient, reduce the hospitalization time, the hospitalization expense and the dosage of the postoperative opioid. It is a good choice for patients with liver cancer after hepatectomy.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.7

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