帕瑞昔布与阿扎司琼联合应用于妇科腹腔镜手术的疗效观察

Efficacy of parecoxib combined with azasetron in patients undergoing gynecological laparoscopic operation

目的观察在妇科腹腔镜手术中联合应用帕瑞昔布与阿扎司琼的临床效果,探讨帕瑞昔布应用后对患者血液流变学参数的影响。方法 60例择期行妇科腹腔镜手术患者随机分为3组,即帕瑞昔布与阿扎司琼联合应用组(PA组),帕瑞昔布组(P组)和阿扎司琼组(A组),每组20例。PA组与P组诱导前及术后8、24h分别静脉给予帕瑞昔布40mg,另外PA组与A组手术结束前15 min静脉给予阿扎司琼10 mg。用视觉模拟评分(VAS)法评估患者术前、术毕和术后6、12、24 h的疼痛程度,观察各组苏醒期躁动、嗜睡、恶心呕吐等不良反应发生情况。术前、术毕及术后48 h检测患者血液流变学参数。结果 PA组和P组苏醒期躁动的发生率及术后疼痛程度明显轻于A组,PA组和A组术后恶心发生率明显低于P组。3组患者血浆黏度、纤维蛋白原和全血黏度各切变率术毕时均显著降低(P<0.05),术后48 h PA、P组恢复至术前水平,而A组高于术前水平(P<0.05),并显著高于PA组和P组(P<0.05)。结论帕瑞昔布与阿扎司琼联合应用于妇科腹腔镜手术可明显减轻术后疼痛和减少恶心呕吐等不良反应。短期应用帕瑞昔布能改善术后血液流变学指标,避免机体处于高凝状态。

AIM To observe the effect of parecoxib combined with azasetron in patients undergoing gynecological laparoseopie operation. METHODS Sixty patients sebeduled for laparoseopie gyneeologieal operation were randomly assigned to 3 groups：pareeoxib combined with azasetron group （group PA） ,pareeoxib group （group P）and azasetron group （group A） with 20 patients each. Before induction and 8,24 h after operation patients in group PA and group P were intravenously injected with pareeoxib 40 mg, respectively. Patients in group PA and group A were intravenously injeeted with azasetron 10mg 15 min before the end of operation. Pain intensity was evaluated with visual analogue scale （VAS） before operation, at the end of operation and 6, 12,24 h after operation individually. The ineidenee rate of restlessness, lethargy, nausea and vomiting after operation were recorded. Hemorheology was tested before operation, at the end of operation and 48 h after operation. RESULTS VAS at the end of operation and 6,12,24 h after operation in group PA and group P had no difference （ P 〉 0.05） and was lower than that of group A （ P 〈 0.05）. The ineidenee rates of nausea and vomiting in group PA and group A were significantly lower than group P （ P 〈 0.05）. The plasma viscoeity, fibrinogen and blood viseoeity of patients in all groups were significantly lower at the end of operation than those before anesthesia （ P 〈 0.05）, in which group A were higher than those in group P and group PA at 48 h after operation （ P 〈 0.05）. CONCLUSION Pareeoxib eombined with azasetron can reduce pain intensity after operation, decrease the incidence rate of restlessness and nausea in patients undergoing gynecological laparoseopie operation and avoid hypereoagulabale state of blood.