發(fā)布時(shí)間：2019-07-08 14:52

【摘要】：目的:探討特異性COX-2抑制劑在肝癌肝切除術(shù)后患者ERAS理念中的鎮(zhèn)痛效果。方法:選擇吉林大學(xué)第一醫(yī)院于2015年4月—2015年12月期間收治的90例肝癌肝切除術(shù)患者。嚴(yán)格按照入組標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn),隨機(jī)分為實(shí)驗(yàn)組、對(duì)照組,其中實(shí)驗(yàn)組50例,對(duì)照組40例。對(duì)照組術(shù)后72小時(shí)內(nèi)每12小時(shí)給予肌內(nèi)注射生理鹽水2ml,試驗(yàn)組在術(shù)后72小時(shí)內(nèi)每12小時(shí)給予肌內(nèi)注射特異性COX-2抑制劑。用統(tǒng)計(jì)學(xué)方法記錄比較二組病人的術(shù)中資料,術(shù)后首次肛門排氣時(shí)間,術(shù)后首次下床時(shí)間,術(shù)后住院費(fèi)用,術(shù)后住院時(shí)間,術(shù)后72h加用阿片類藥物鎮(zhèn)痛次數(shù),術(shù)后3天疼痛評(píng)分,術(shù)后并發(fā)癥、不良反應(yīng)等。結(jié)果:與對(duì)照組相比,實(shí)驗(yàn)組患者的術(shù)后首次肛門排氣時(shí)間、術(shù)后首次下床時(shí)間、術(shù)后住院時(shí)間明顯縮短,術(shù)后住院費(fèi)用降低,術(shù)后72小時(shí)加用阿片類藥物次數(shù)減少,術(shù)后3天的疼痛評(píng)分降低,術(shù)后發(fā)生胸水例數(shù)、惡心嘔吐、呼吸抑制例數(shù)均減少,差異有統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論:肝癌肝切除術(shù)患者術(shù)后早期使用特異性COX-2抑制劑安全、有效,能顯著緩解患者肝癌肝切除術(shù)后的疼痛程度,促進(jìn)患者術(shù)后的恢復(fù),減少住院時(shí)間、住院費(fèi)用及術(shù)后阿片類藥物的用量,是肝癌肝切除術(shù)后患者鎮(zhèn)痛的良好選擇。
[Abstract]:Objective: To study the analgesic effect of specific COX-2 inhibitor in the post-hepatectomy of patients with liver cancer. Methods:90 patients with hepatic resection of liver cancer were selected from the first hospital in Jilin University from April 2015 to December 2015. The experimental group and the control group were randomly divided into the experimental group and the control group according to the criteria of the inclusion and the exclusion criteria. Intramuscular injection of 2 ml of saline was administered intramuscularly every 12 hours after 72 hours after the control group, and the test group was given an intramuscular injection specific COX-2 inhibitor every 12 hours after 72 hours of operation. The operative data of the two groups of patients were recorded by the statistical method. The first time after the operation, the first time after operation, the post-operative hospitalization, the postoperative hospital stay, the number of opioid analgesic after 72 hours after operation, the postoperative 3-day pain score, the postoperative complications, the adverse reaction, etc. Results: Compared with the control group, the first time after the operation of the experimental group, the first time after the operation, the time of the hospital stay was significantly shortened, the hospital cost was reduced, the number of opioid drugs was decreased in 72 hours after operation, and the pain score of 3 days after operation was reduced. The number of pleural effusion, nausea and vomiting and the number of respiratory depression were reduced after operation, and the difference was statistically significant (P <0.05). Conclusion: The use of specific COX-2 inhibitor is safe and effective in the early stage of the patients with liver cancer, and can obviously relieve the pain degree after the liver resection of the liver cancer of the patient, promote the recovery after the operation of the patient, reduce the hospitalization time, the hospitalization expense and the dosage of the postoperative opioid. It is a good choice for patients with liver cancer after hepatectomy.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.7

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