發(fā)布時(shí)間：2018-04-25 09:13

  本文選題：超前鎮(zhèn)痛 + 塞來昔布��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的觀察塞來昔布超前鎮(zhèn)痛用于腹股溝疝無張力修補(bǔ)術(shù)的效果,評(píng)估其在腹股溝疝無張力修補(bǔ)術(shù)應(yīng)用中的有效性和安全性。方法(1)收集青島市中心醫(yī)院疝和腹壁外科自2016年1月-12月100例擇期行單側(cè)腹股溝疝無張力修補(bǔ)術(shù)的男性患者,將其隨機(jī)分為治療組(A組)和對(duì)照組(B組),每組各50例,治療組于術(shù)前24h和12h分別口服塞來昔布200mg,術(shù)后不用藥,對(duì)照組術(shù)前、術(shù)后均不用藥。治療組和對(duì)照組兩組患者均行腹股溝疝無張力修補(bǔ)術(shù),而且都使用同等劑量的利多卡因注射液進(jìn)行局部浸潤(rùn)麻醉來完成手術(shù)。(2)兩組患者均于術(shù)后2、4、8、12采用視覺模擬評(píng)分(VAS)和最高VAS評(píng)分對(duì)患者疼痛程度進(jìn)行疼痛分級(jí)評(píng)分。(3)對(duì)比兩組患者的術(shù)后各項(xiàng)指標(biāo),其包括術(shù)后使用補(bǔ)救性鎮(zhèn)痛藥物曲馬多的例數(shù)、術(shù)后的各類不良反應(yīng),平均的術(shù)后住院時(shí)長(zhǎng),患者手術(shù)結(jié)束時(shí)及術(shù)后24h分別抽取外周血2m L,測(cè)定外周血Hs-CRP水平。結(jié)果(1)治療組患者術(shù)后2、4、8、12 h的VAS評(píng)分及術(shù)后最高VAS評(píng)分均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);(2)術(shù)后治療組和對(duì)照組分別有3例和11例患者使用曲馬多,差異有統(tǒng)計(jì)學(xué)意義(χ2=5.175,P=0.023);治療組和對(duì)照組患者術(shù)后分別有2例和8例患者發(fā)生不良反應(yīng),差異有統(tǒng)計(jì)學(xué)意義(χ2=3.927,P=0.048);治療組術(shù)后住院時(shí)間短于對(duì)照組(P0.05);(3)分別統(tǒng)計(jì)兩組患者手術(shù)結(jié)束時(shí)及術(shù)后24h外周血超敏C-反應(yīng)蛋白(Hs-CRP)的水平,結(jié)果證實(shí)治療組Hs-CRP水平明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論塞來昔布作為目前臨床上常用的超前鎮(zhèn)痛藥物,其術(shù)后鎮(zhèn)痛效果確切,患者滿意度較高,不良反應(yīng)明顯減少,有利于患者早日康復(fù),可以廣泛的應(yīng)用于腹股溝疝無張力修補(bǔ)術(shù)。
[Abstract]:Objective to evaluate the efficacy and safety of celecoxib preemptive analgesia in the tension-free repair of inguinal hernia. Methods from January to December 2016, 100 male patients with unilateral inguinal hernia tension-free repair were randomly divided into treatment group A (n = 50) and control group B (n = 50). Celecoxib 200 mg was taken orally at 24 hours and 12 hours before operation in the treatment group and no drug was given before and after operation in the control group. Tension-free repair of inguinal hernia was performed in both the treatment group and the control group. Both groups were treated with the same dose of lidocaine injection for local infiltration anesthesia to complete the operation.) both groups were assessed with visual analogue score (VASS) and maximum VAS score for the pain degree. (3) comparing the postoperative indexes between the two groups, It included the cases of tramadol, the adverse reactions after operation, the average length of stay in hospital after operation, and the level of Hs-CRP in peripheral blood taken from the patients at the end of operation and 24 hours after operation, respectively. Results 1) the VAS scores and the highest VAS scores in the treatment group were significantly lower than those in the control group at 12 h after operation (P 0.05). There were 3 cases in the treatment group and 11 cases in the control group, and tramadol was used in the treatment group and the control group, respectively. The difference was statistically significant (蠂 ~ 2 = 5.175), the adverse reactions occurred in 2 cases and 8 cases in the treatment group and the control group, respectively. The difference was statistically significant (蠂 ~ 2 / 3.927 / P ~ (0.048)). The postoperative hospitalization time of the treatment group was shorter than that of the control group (P _ (0.05)). The levels of Hs-CRP in peripheral blood of the two groups were calculated at the end of operation and 24 hours after operation. The results showed that the level of Hs-CRP in the treatment group was significantly lower than that in the control group. The difference was statistically significant (P 0.05). Conclusion Celecoxib is a commonly used preemptive analgesic drug in clinical practice at present. The postoperative analgesia effect of celecoxib is accurate, the patient satisfaction is higher, and the adverse reaction is obviously reduced, which is beneficial to the early recovery of the patients. It can be widely used in inguinal hernia tension-free repair.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R614

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