本文選題：兒童　切入點：扁桃體切除術　出處：《臨床耳鼻咽喉頭頸外科雜志》2017年14期

【摘要】：目的:觀察兒童扁桃體切除術后種鎮(zhèn)痛方式應激疼痛反應的變化。方法:124例兒童扁桃體切除術后的兒童,隨機分為A、B兩組,分別為60例和64例。手術后A組為使用靜脈自控鎮(zhèn)痛藥物持續(xù)靜脈輸注,B組根據(jù)患兒年齡及體重選擇小劑量(5mg/kg/次)布洛芬混懸液口服。手術前后24h采用FLACC進行鎮(zhèn)痛評分。術前及術后24h均檢測血白細胞(WBC)、血清C反應蛋白(CRP)和皮質醇(COR)濃度;檢測WBC、CRP和COR濃度行相關性。結果:反應疼痛應激4個指標中,FLACC和COR判斷疼痛效能最好,CRP和WBC較差。術后4、24、36h3個時間段,對患兒進行FLACC評分,B與A組同時段相比差異有統(tǒng)計學意義(P0.05),各組組間比較差異沒有統(tǒng)計學意義;患兒手術前后A、B組對外周血WBC數(shù)目,CRP和COR的濃度變化:A組CRP和COR的濃度手術前后比較差異有統(tǒng)計學意義(P0.05);COR的濃度24hA組與B組比較差異有統(tǒng)計學意義(P0.05)。結論:兒童扁桃體切除術后應激疼痛可以用FLACC評分和測血清COR濃度綜合判定,布洛芬混懸液口服可以減小患兒應激疼痛反應,安全滿足術后用鎮(zhèn)痛需要。
[Abstract]:Objective: to observe the changes of stress pain response after tonsillectomy in children. Methods: 124 children with tonsillectomy were randomly divided into two groups. There were 60 cases and 64 cases of ibuprofen suspension in group A after operation. Group B received continuous intravenous infusion of intravenous controlled analgesic drugs according to the age and weight of the children. Ibuprofen suspension was taken orally at a low dose of 5 mg / kg / time before and 24 hours before and after operation. FLACC was used to treat the patients 24 hours before and after operation. Pain score. WBC, serum C-reactive protein (CRP) and cortisol Corr were measured before and 24 hours after operation. Results: FLACC and COR were the best indexes in judging pain. There was significant difference in FLACC score between group A and group B in the same period (P 0.05), but there was no significant difference between each group. Changes of WBC and COR in peripheral blood of children before and after operation there is a significant difference in the concentration of CRP and COR between group A and group A before and after operation. There is a significant difference between group 24hA and group B in the concentration of CRP and COR. Conclusion: there is a significant difference in the concentration of CRP and COR between group B and group B.Conclusion: there is a significant difference between group A and group B in the concentration of CRP and COR. Stress pain after tonsillectomy can be determined by FLACC score and serum COR concentration. Ibuprofen suspension can reduce the stress pain response and meet the postoperative analgesic needs.
【作者單位】： 華中科技大學同濟醫(yī)學院附屬武漢兒童醫(yī)院(武漢市婦幼保健院)耳鼻咽喉科;
【分類號】：R766.9

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本文編號：1667433