不同镇痛模式在老年患者髋部手术术后的应用效果
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摘要
目的探讨不同镇痛模式在老年患者髋部手术术后的应用效果。方法选取2014年1月～2018年6月在我院接受髋部手术治疗的100例老年患者作为研究对象,按镇痛模式不同分为对照组和观察组,每组各50例。对照组给予留置静脉自控式镇痛泵(内含药物为舒芬太尼、盐酸托烷司琼、生理盐水)镇痛,观察组给予帕瑞昔布静脉注射镇痛,观察并比较两组患者的疼痛VAS评分、术后镇痛满意度及不良反应发生率。结果观察组患者术后2、12、24 h的疼痛VAS评分均显著低于对照组(P<0.05)。观察组患者的总满意率为94.00%,显著高于对照组的80.00%(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论帕瑞昔布在老年患者髋部手术术后镇痛的应用中有确切疗效,能提高患者满意度,降低不良反应发生率,有利于促进患者术后身体康复及进行功能锻炼,值得临床推广应用。
Objective To explore the clinical effect of different analgesic modes in elderly patients after hip surgery.Methods A total of 100 elderly patients who were accepted hip surgery in our hospital from January 2014 to June 2018 were selected as study subjects and divided into the control group and the observation group according to different analgesic patterns, with 50 cases in each group. Patients in the control group were treated with intravenous analgesia pump(included Sufentanil, Tropisetron Hydrochloride and Saline), and those in the observation group were treated with Parecoxib intravenously. The pain VAS scores, postoperative analgesic satisfaction and the incidence rate of adverse reaction were observed and compared between the two groups. Results The VAS scores of the observation group at 2,12, 24 h after surgery were significantly lower than those of the control group(P<0.05). The total satisfaction rate of the observation group was 94.00%, which was significantly higher than that in the control group(80.00%)(P<0.05). There was no statistical difference in the total incidence rate of adverse reaction between the two groups(P>0.05). Conclusion Parecoxib has obvious curative effect on postoperative analgesia in elderly patients with hip surgery. It can improve the patients′ satisfaction while reduce the rate of adverse reactions. It is benefic to promote postoperative physical recovery and functional exercise. It is worthy of clinical promotion and application.
Objective To explore the clinical effect of different analgesic modes in elderly patients after hip surgery.Methods A total of 100 elderly patients who were accepted hip surgery in our hospital from January 2014 to June 2018 were selected as study subjects and divided into the control group and the observation group according to different analgesic patterns, with 50 cases in each group. Patients in the control group were treated with intravenous analgesia pump(included Sufentanil, Tropisetron Hydrochloride and Saline), and those in the observation group were treated with Parecoxib intravenously. The pain VAS scores, postoperative analgesic satisfaction and the incidence rate of adverse reaction were observed and compared between the two groups. Results The VAS scores of the observation group at 2,12, 24 h after surgery were significantly lower than those of the control group(P<0.05). The total satisfaction rate of the observation group was 94.00%, which was significantly higher than that in the control group(80.00%)(P<0.05). There was no statistical difference in the total incidence rate of adverse reaction between the two groups(P>0.05). Conclusion Parecoxib has obvious curative effect on postoperative analgesia in elderly patients with hip surgery. It can improve the patients′ satisfaction while reduce the rate of adverse reactions. It is benefic to promote postoperative physical recovery and functional exercise. It is worthy of clinical promotion and application.
引文
[1]宋青凤,李光文,李良业,等.丙帕他莫联合静脉自控镇痛泵对75岁以上老年髋部骨折患者术后的镇痛效果[J].中华老年多器官疾病杂志,2017,16(8):591-594.
[2]周武,高飞,米博斌,等.老年髋部骨折患者围手术期辅助治疗进展[J].中国老年骨科与康复电子杂志,2017,3(5):317-320.
[3]李强,刘科,魏运栋.多模式镇痛对高龄老年腰椎退变性疾病术后疼痛及应激反应的影响研究[J].河北医药,2017,39(1):84-87,91.
[4]陈晓明,朱见伟,王长富.不同方式的镇痛方法对于老年髋部手术术后镇痛的临床观察[J].医学信息,2016,29(29):100-101.
[5]翁科迪,曹铨,石钢,等.帕瑞昔布钠超前镇痛对老年股骨转子间骨折术后镇痛及谵妄的影响[J].浙江中西医结合杂志,2016,26(8):741-744.
[6]陈晓明,朱见伟,谭雅儒.CFNB、PCIA联合塞来昔布用于老年髋部骨折术后镇痛效果比较[J].山东医药,2016,56(18):85-87.
[7]王海侠,李先会,周敏,等.老年髋部骨折术后静脉镇痛泵不同拔除时间疗效观察[J].实用临床医药杂志,2017,21(22):167-168.
[8]李晨美,杨红飞,曹桂珍,等.多模式围手术期镇痛在老年髋部手术中的应用[J].泰山医学院学报,2014,35(12):1284-1285.
[9]武栋,程斌,高茂龙.小剂量纳美芬在老年髋部骨折患者术后静脉自控镇痛中的应用[J].首都医科大学学报,2016,37(2):241-244.
[10]李奕良,李运繁,全丹雄.舒芬太尼联合右美托咪定及托烷司琼对老年髋部手术患者术后镇痛及谵妄的影响[J].中国医院用药评价与分析,2017,17(11):1474-1476.
[11]李运繁,陈建廷,龙家棋,等.小剂量右美托咪定自控镇痛对老年髋部骨折患者术后早期认知功能的影响[J].今日药学,2018,28(4):259-261.
[12]姚凤珍,黄礼兵,季淑娟,等.帕瑞昔布用于膝关节镜手术后镇痛的临床研究[J].实用药物与临床,2010,13(5):335-336.
[13]赵志钢,卢建华.帕瑞昔布钠用于老年人下肢骨科手术术后镇痛的观察[J].临床和实验医学杂志,2011,10(14):1116-1117.
[14]何秀莉,苏鸿莉.帕瑞昔布钠复合小剂量舒芬太尼用于老年股骨头置换术后患者的镇痛[J].陕西医学杂志,2015,44(10):1411-1412.
[15]陈迪坤,张鹤鸣.多模式镇痛对老年髋部骨折术后谵妄影响的研究[J].世界最新医学信息文摘,2017,17(61):55.
[2]周武,高飞,米博斌,等.老年髋部骨折患者围手术期辅助治疗进展[J].中国老年骨科与康复电子杂志,2017,3(5):317-320.
[3]李强,刘科,魏运栋.多模式镇痛对高龄老年腰椎退变性疾病术后疼痛及应激反应的影响研究[J].河北医药,2017,39(1):84-87,91.
[4]陈晓明,朱见伟,王长富.不同方式的镇痛方法对于老年髋部手术术后镇痛的临床观察[J].医学信息,2016,29(29):100-101.
[5]翁科迪,曹铨,石钢,等.帕瑞昔布钠超前镇痛对老年股骨转子间骨折术后镇痛及谵妄的影响[J].浙江中西医结合杂志,2016,26(8):741-744.
[6]陈晓明,朱见伟,谭雅儒.CFNB、PCIA联合塞来昔布用于老年髋部骨折术后镇痛效果比较[J].山东医药,2016,56(18):85-87.
[7]王海侠,李先会,周敏,等.老年髋部骨折术后静脉镇痛泵不同拔除时间疗效观察[J].实用临床医药杂志,2017,21(22):167-168.
[8]李晨美,杨红飞,曹桂珍,等.多模式围手术期镇痛在老年髋部手术中的应用[J].泰山医学院学报,2014,35(12):1284-1285.
[9]武栋,程斌,高茂龙.小剂量纳美芬在老年髋部骨折患者术后静脉自控镇痛中的应用[J].首都医科大学学报,2016,37(2):241-244.
[10]李奕良,李运繁,全丹雄.舒芬太尼联合右美托咪定及托烷司琼对老年髋部手术患者术后镇痛及谵妄的影响[J].中国医院用药评价与分析,2017,17(11):1474-1476.
[11]李运繁,陈建廷,龙家棋,等.小剂量右美托咪定自控镇痛对老年髋部骨折患者术后早期认知功能的影响[J].今日药学,2018,28(4):259-261.
[12]姚凤珍,黄礼兵,季淑娟,等.帕瑞昔布用于膝关节镜手术后镇痛的临床研究[J].实用药物与临床,2010,13(5):335-336.
[13]赵志钢,卢建华.帕瑞昔布钠用于老年人下肢骨科手术术后镇痛的观察[J].临床和实验医学杂志,2011,10(14):1116-1117.
[14]何秀莉,苏鸿莉.帕瑞昔布钠复合小剂量舒芬太尼用于老年股骨头置换术后患者的镇痛[J].陕西医学杂志,2015,44(10):1411-1412.
[15]陈迪坤,张鹤鸣.多模式镇痛对老年髋部骨折术后谵妄影响的研究[J].世界最新医学信息文摘,2017,17(61):55.