本文選題：急腹癥　切入點：丁丙諾啡　出處：《中國老年學(xué)雜志》2017年15期 　論文類型：期刊論文

【摘要】：目的探討丁丙諾啡對老年急腹癥手術(shù)患者的鎮(zhèn)痛作用。方法將82例老年急腹癥擬行手術(shù)治療的患者,利用隨機(jī)數(shù)字表法分為觀察組和對照組。對照組給予常規(guī)麻醉,觀察組在常規(guī)麻醉的基礎(chǔ)上給予丁丙諾啡超前鎮(zhèn)痛。對比兩組術(shù)中生命體征指標(biāo)變化、術(shù)后疼痛評分、血清C反應(yīng)蛋白(CRP)、皮質(zhì)醇(Cor)濃度變化,并對比兩組術(shù)后靜脈自控鎮(zhèn)痛藥物用量及不良反應(yīng)發(fā)生情況。結(jié)果插管后即刻和插管5 min后對照組平均動脈壓(MAP)、心率(HR)均明顯升高(P0.05),動脈血氧飽和度(SpO_2)水平均顯著降低(P0.05),而觀察組均無顯著變化(P0.05);插管后即刻和插管5 min后觀察組MAP、HR均明顯低于對照組(P0.05),而SpO_2明顯高于對照組(P0.05);兩組疼痛評分均隨著時間的推移不斷降低(P0.05),且各時刻觀察組的評分均明顯低于對照組(P0.05);術(shù)后6 h和術(shù)后12 h兩組血清CRP、Cor濃度均顯著升高(P0.05),但觀察組血清CRP、Cor濃度均明顯低于對照組(P0.05);觀察組術(shù)后靜脈自控鎮(zhèn)痛藥物用量明顯少于對照組(P0.05),兩組術(shù)后均無明顯不良反應(yīng)。結(jié)論對老年急腹癥手術(shù)患者實施丁丙諾啡超前鎮(zhèn)痛并不會導(dǎo)致生命體征指標(biāo)變化且不增加不良反應(yīng),可有效減輕術(shù)后疼痛和手術(shù)應(yīng)激反應(yīng)。
[Abstract]:Objective to investigate the analgesic effect of buprenorphine on elderly patients with acute abdomen. Methods Eighty-two elderly patients with acute abdomen were divided into observation group and control group by random digital table. In the observation group, buprenorphine preemptive analgesia was given on the basis of routine anesthesia. The changes of vital signs, postoperative pain scores, serum C-reactive protein (CRP) and cortisol Corn were compared between the two groups. Results immediately after intubation and 5 min after intubation, the mean arterial pressure (map) and heart rate (HR) in the control group were significantly higher than those in the control group (P 0.05), and the level of arterial oxygen saturation (SPO _ 2) was significantly higher than that in the control group. After intubation and 5 min after intubation, the HR of MAPP in observation group was significantly lower than that in control group (P 0.05), while SpO_2 was significantly higher than that in control group (P 0.05). The pain scores of both groups were decreased with time, and each group was significantly lower than that of control group (P 0.05). The score of the observation group was significantly lower than that of the control group (P0.05), the serum CRPnCor concentration of the two groups was significantly higher than that of the control group at 6 h and 12 h postoperatively, but the concentration of CRPnCor in the observation group was significantly lower than that in the control group. The dosage of buprenorphine was significantly lower than that of the control group (P 0.05), and there was no significant adverse reaction in both groups. Conclusion buprenorphine preemptive analgesia in elderly patients with acute abdominal surgery does not cause changes in vital signs and does not increase adverse reactions. It can effectively relieve postoperative pain and stress response.
【作者單位】： 沈陽市紅十字會醫(yī)院麻醉科;
【分類號】：R614
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本文編號：1651128