氯诺昔康复合芬太尼对冠心病患者术后心肌缺血的影响

Effect of lornoxicam combined with fentanyl on postoperative myocardial ischemia in patients with coronary heart disease undergoing abdominal surgery

目的研究氯诺昔康复合芬太尼对冠心病(CHD)患者术后心肌缺血的影响。方法120例择期腹部手术CHD患者随机分为两组,每组60例。A组术中及术后用氯诺昔康复合芬太尼镇痛,B组术中及术后用芬太尼镇痛。记录术后4、12、24、48h视觉模拟评分(VAS),术后1～8d动态心电图监测S-T改变。结果两组病人术后4、12、24、48hVAS评分均<3分。A组术后第8天心肌缺血发生率明显比B组少(P<0.05)。结论术中、术后应用氯诺昔康复合芬太尼镇痛可有效降低CHD患者术后心肌缺血发生率,可能与抑制血小板活化有关。

Objective To investigate the effects of lornoxicam combined with fentanyl on postoperative myocardial ischemia in patients with coronary heart disease （CHD） undergoing abdominal surgery. Methods One hundred and twenty CHD patients undergoing abdominal surgery were randomly divided into two groups with 60 cases each. The patients in group A were given lornoxicam combined with fentanyl during operation and postoperative patient-controlled intravenous anaJ, gesia（PCIA） and those in group B fentanyl only. The intensity of pain was assessed by visual analogue seale（VAS） and the changes of S-T segment were detected by Holter monitor in 1 to 8 days after operation. Results VAS scores of two groups were all less than 3 during postoperative analgesia. The incidence of myocardial ischemia in group A was significantly lower in group A than that in group B on the 8th day after operation （P〈0.05）. Conclusion Lornoxicam combined with fentanyt therapy can more effectively reduce the incidence of postoperative myocardial ischemia in the cardiac patients undergoing abdominal surgery. It may contribute to the impairment of platelet function.