本文關(guān)鍵詞： 前列腺 穿刺 疼痛 麻醉 氟比洛芬酯　出處：《北京大學(xué)學(xué)報(醫(yī)學(xué)版)》2017年04期 　論文類型：期刊論文

【摘要】：目的:探索氟比洛芬酯靜脈應(yīng)用能否減輕經(jīng)直腸超聲引導(dǎo)下前列腺穿刺引起的疼痛。方法:采用隨機、對照研究方法,共入選81例于北京大學(xué)人民醫(yī)院泌尿外科住院行經(jīng)直腸超聲引導(dǎo)下前列腺穿刺患者,隨機分為3組(每組27例),分別是:直腸內(nèi)局部表面麻醉(intrarectal local anesthesia,IRLA)組:術(shù)前5 min 5%(0.05 g/L)利多卡因凝膠60 mg直腸內(nèi)局部表面麻醉;氟比洛芬酯(flurbiprofen axetil,FA)組:術(shù)前1 h氟比洛芬酯靜脈滴注(1 mg/kg);IRLA+FA組:術(shù)前5 min 5%利多卡因凝膠60 mg直腸內(nèi)局部表面麻醉,同時術(shù)前1 h氟比洛芬酯靜脈滴注(1 mg/kg)。使用視覺模擬評分表(visual analogue scale,VAS)評估超聲探頭插入肛門時(VASⅠ)、麻醉過程中(VASⅡ)、穿刺活檢時(VASⅢ)及術(shù)后20 min時(VASⅣ)的疼痛評分。使用單因素協(xié)方差分析比較3組間患者基線差異。疼痛評分的組間差異采用參數(shù)檢驗的單因素協(xié)方差分析。隨后采用圖基(Tukey)事后檢驗法進行各組間比較:P1、P2、P3分別為IRLA組和FA組、FA組和IRLA+FA組、IRLA組和IRLA+FA組的組間差異P值,P0.05認(rèn)為差異有統(tǒng)計學(xué)意義,其中組間兩兩比較采用Bonferroni方法調(diào)整檢驗水準(zhǔn)α=0.017。結(jié)果:所有患者未見嚴(yán)重的術(shù)后并發(fā)癥。3組患者的基線數(shù)據(jù)差異無統(tǒng)計學(xué)意義,VASⅡ(5.7±2.2,3.0±1.5,3.3±1.9,P=0.012)和VASⅢ(6.7±2.3,3.0±2.1,2.9±1.6,P=0.001)差異有統(tǒng)計學(xué)意義;VASⅠ(3.2±1.0,4.1±2.1,4.2±1.7,P=5.752)和VASⅣ(1.4±2.1,1.0±0.9,1.1±0.7,P=3.772)差異無統(tǒng)計學(xué)意義。兩兩組間差異,在VASⅣ(P1=0.007,P2=5.655,P3=0.001)和VASⅢ(P1=0.008,P2=7.517,P3=0.001)方面,IRLA組和FA組、IRLA組和IRLA+FA組的組間差異有統(tǒng)計學(xué)意義。結(jié)論:氟比洛芬酯能安全、有效地減輕經(jīng)直腸超聲引導(dǎo)下的前列腺穿刺術(shù)患者的疼痛。
[Abstract]:Objective: to explore whether the intravenous application of flurbiprofen ester can alleviate the pain caused by transrectal ultrasound guided prostate puncture. A total of 81 patients who underwent transrectal ultrasound guided prostate puncture in urology department of Peking University people's Hospital were randomly divided into 3 groups (27 cases in each group). They were intrarectal local anesthesia. Irla group: 5 min / 5 g / L Lidocaine gel 60 mg intrarectal topical anesthesia before operation; Flurbiprofen axetilFAA group: flurbiprofen flurbiprofen axetilFAA group: 1 mg / kg flurbiprofen intravenously injected flurbiprofen 1 h before operation; IRLA FA group: 5 min 5% lidocaine gel 60 mg intrarectal topical anesthesia. At the same time, 1 mg / kg flurbiprofen ester was injected intravenously 1 h before operation. Visual analogue scale was evaluated by visual analogue scale. Vas) was used to evaluate VAS 鈪，

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