摘要
目的探讨地佐辛对关节镜术后疼痛患者的疗效、安全性及生活质量的影响。方法选择2018年3月至2019年6月我院60例择期行关节镜手术治疗患者作为研究对象,根据随机数字分配法分为观察组和对照组,每组30例。两组均予以关节镜手术治疗,并接受咪唑安定、丙泊酚血浆靶控、芬太尼及维库溴铵麻醉诱导。维库溴铵静注后3 min行气管插管,插管后予机械通气。对照组患者切皮前5 min静脉注射地佐辛0.1 mg/kg;观察组患者切皮前5 min及手术结束即刻分别静脉注射地佐辛0.1 mg/kg。术中予以丙泊酚、瑞芬太尼、七氟烷及维库溴铵维持麻醉。手术结束前20 min停用七氟烷,手术结束前10 min予芬太尼2.0μg/kg,逐步减小丙泊酚用量直至停止。采用视觉模拟评分法(VAS)对术后4 h、8 h、12 h、24 h、48 h疼痛程度进行评价;采用ADL评分法对患者1、3、6个月生活质量进行评价;同时评估满意度、住院时间、术后并发症及不良反应发生率。结果与对照组相比,观察组患者术后4 h、8 h、12 h、24 h的VAS评分较低,差异有统计学意义(P<0.05);对照组与观察组术后4 h、8 h、12 h、24 h VAS评分依次降低,差异有统计学意义(P<0.05)。两组治疗前ADL评分比较差异无统计学意义(P>0.05)。与治疗前相比,观察组治疗后1、3、6个月ADL评分较高(P<0.05);对照组与观察组治疗后1、3、6个月ADL评分依次升高,差异有统计学意义(P<0.05)。与对照组相比,观察组满意度较高,住院时间缩短,术后并发症发生率较低,差异有统计学意义(P<0.05)。对照组不良反应总发生率为20.00%(6/30),观察组不良反应总发生率为23.33%(7/30),两组比较差异无统计学意义(P>0.05)。结论地佐辛对关节镜术后疼痛具有缓解作用,能改善关节镜术后治疗效果,提高生活质量,且能缩短住院时间,患者满意度较高。
Objective To investigate the effect of dizosin on the efficacy,safety and quality of life in patients with pain after arthroscopy.Methods Totally 60 patients receiving arthroscopic surgery in our hospital from March 2018 to June 2019 were selected,and were divided into observation group and control group according to the random number distribution method,30 patients in each group.The 2 groups were treated with arthroscopic surgery,and received midazolam,propofol plasma target control,fentanyl and vecuronium anesthesia induction.Tracheal intubation was performed 3 min after intravenous injection of vecuronium,and mechanical ventilation was performed after intubation.In control group,0.1 mg/kg of dizosin was injected intravenously 5 min before skin cutting,and in the observation group,0.1 mg/kg of dizosin was injected intravenously 5 min before skin cutting and immediately after operation.Propofol,remifentanil,sevoflurane and vecuronium were used to maintain anesthesia.Sevoflurane was stopped 20 min before the the end of operation,fentanyl 2.0μg/kg was given 10 min before the the end of operation,and propofol was gradually reduced until it was stopped.The degree of pain was evaluated by VAS at 4 h,8 h,12 h,24 h and 48 h after operation;the quality of life at 1,3 and 6 months was evaluated by ADL;satisfaction,length of stay at hospital,postoperative complications and incidence of adverse reactions were evaluated.Results Compared with the control group,the VAS scores of patients in observation group were lower at 4 h,8 h,12 h and 24 h after operation,the difference was statistically significant(P<0.05);the VAS scores of patients in control group and observation group were gradualy reduced with time at 4 h,8 h,12 h and 24 h after operation,the difference being statistically significant(P<0.05).There was no significant difference in ADL between the two groups before treatment(P>0.05).Compared with that before treatment,the ADL score of observation group was higher at 1,3 and 6 months after treatment,and the difference was statistically significant(P<0.05);the ADL score of control group was gradually higher with time at 1,3 and 6 months after treatment,the difference being statistically significant(P<0.05).Compared with control group,observation group had higher satisfaction,shorter hospital stay and lower incidence of postoperative complications(P<0.05).There was no significant difference in the incidence of adverse reactions between observation group(23.33%,7/30)and control group(20.00%,6/30)(P>0.05).Conclusion Dizosin can relieve the pain after arthroscopy,improve the quality of life,improve the patients′satisfaction and shorten the hospitalization time.
作者
赵兰
陈亚凤
贾瑛
燕明
刘静
ZHAO Lan;CHEN Ya-feng;JIA Ying;YAN Ming;LIU Jing(Department of Orthopaedics,the First Affiliated Hospital of Air Force Military Medical University,Xi′an 710032,China)
出处
《实用药物与临床》
CAS
2020年第8期733-736,共4页
Practical Pharmacy and Clinical Remedies
基金
陕西科技厅科学技术研究计划(2018kjxx33)。
