不同模式鎮痛在婦科微創手術患者中的應用

DOI：10.16662/j.cnki.1674-0742.2016.32.061

[摘要] 目的 探討不同模式鎮痛在婦科微創手術中的應用有效性與安全性。方法 方便選取2013年1月—2016年6月該院婦科收治的65例微創手術患者為研究對象，隨機分3組。A組患者術后靜注地佐辛鎮痛；B組患者術后以芬太尼聯合地佐辛鎮痛；C組患者于術畢前30 min靜注地佐辛鎮痛。以VAS疼痛評分和Ramsay鎮靜評分于術后不同時段對患者的鎮痛效果和鎮靜效果進行評估，觀察患者用藥后不良反應。 結果 A、B、C 3組鎮痛優良率分別為80.95%、95.45%和90.91%，B組、C組鎮痛優良率高于A組，差異均有統計學意義（P<0.05）。結論 婦科微創術后以地佐辛和芬太尼給予患者超前鎮痛或聯合鎮痛，其鎮痛效果優于術后單一用藥鎮痛且不會加重患者不良反應。

[關鍵詞] 婦科微創；術后鎮痛；聯合鎮痛；超前鎮痛

[中圖分類號] R713 [文獻標識碼] A [文章編號] 1674-0742（2016）11（b）-0061-03

Application of Different Mode of Analgesia in Patients with Gynecologic Minimally Invasive Surgery

ZONG Kui

Department of Anesthesia， the Second People's Hospital of Changshou City ， Jiangsu Province， Changshou ， Jiangsu Province，215500 China

[Abstract] Objective To explore the effectiveness and safety of different modes of analgesia in gynecologic minimally invasive surgery. Methods Convenient selection 65 cases of minimally invasive surgery in our hospital from January 2013 to June 2016 in our hospital were randomly divided into three groups， patients were randomly divided into groups. Note dezocine analgesia after a group of patients undergoing intravenous for； patients in group B with fentanyl combined with dezocine analgesia； group C patients in postoperative 30 min static note dezocine analgesia. The analgesic effect and sedative effect of VAS pain score and Ramsay sedation score at different time periods were evaluated， and the adverse drug reaction was observed. Results The good rates of analgesia in A， B and C were 80.95%， 95.45% and 90.91%， and the good rate of analgesia in group B and group C was higher than that in group A ，the difference was statistically significant（P < 0.05）. Conclusion After gynecologic minimally invasive surgery with dezocine and fentanyl given patients preemptive analgesia or joint pain， the analgesic effect is better than that of the operation of single drug analgesia without aggravating the adverse reactions in patients.

[Key words] Gynecological minimally invasive surgery； Postoperative analgesia； Combined analgesia；Preemptive analgesia

現階段，醫療技術進步使得內鏡手術、陰式手術等微創治療方法廣泛應用于婦科臨床，在降低手術創傷、加速患者康復、實現術后美觀方面發揮著重要作用，故備受女性患者好評[1]。文章現以2013年1月—2016年6月該院婦科收治的65例微創手術患者為研究對象，對不同用藥下患者自控鎮痛的療效進行分析和探討，現報道如下。

1 資料與方法

1.1 一般資料

方便選取該院婦科收治的65例微創手術患者為研究對象，隨機將入選病例分為3組。A組21例，患者年齡21～64歲，平均年齡（43.5±7.6）歲；B組22例，患者年齡22～60歲，平均年齡（43.4±7.3）歲；C組22例，患者年齡21～63歲，平均年齡（43.8±7.2）歲。3組患者基本臨床資料差異無統計學意義（P>0.05），具有可比性。

1.2 方法

全部患……