酮咯酸氨丁三醇与氟比洛芬酯用于老年股骨粗隆间骨折术后镇痛的对比研究

COMPARISON OF CURATIVE EFFECT BETWEEN KETOROLAC TROMETHAMINE AND FLURBIPROFEN FOR POSTOPERATIVE PAIN RELIEF ON INTERTROCHANTERIC FRACTURES IN ELDERLY

目的比较酮咯酸氨丁三醇和氟比洛芬酯用于老年股骨粗隆间骨折患者术后疼痛的疗效差异。方法58例行股骨粗隆间骨折内固定，年龄在62～78岁的患者随机分为两组，各29例。酮咯酸氨丁三醇治疗组（T组）：酮咯酸氨丁三醇注射液60mg＋生理盐水100ml；氟比洛芬酯治疗组（F组）：氟比洛芬酯注射液100mg＋生理盐水100ml，均待镇痛效果不佳时静滴给药。采用疼痛视觉模拟评分法（VAS）评估患者给药后30min、1h、4h,8h、12h、24h等时间点疼痛缓解情况，Ramsay镇静评分评估以上时间点两组药物的镇静效果，并记录两组患者用药后不良反应和患者对术后镇痛效果的总体满意度。结果F组术后8、12h的VAS评分明显高于T组，而T组术后4、8、12h的Ramsay得分低于F组，差异均有统计学意义（p〈0．05），T组术后不良反应发生率低于F组，患者的整体镇痛满意度也更高。结论两种药物均可用于老年粗隆间骨折术后镇痛，而酮咯酸氨丁三醇因其良好的镇痛效果、较低的不良反应发生率、患者满意度较高而更适合此类人群。

Objective To compare the efficacy of ketorolac tromethamine and flurbiprofen for intertrochanteric fractures in elderly patients with postoperative pain. Methods A total of 58 patients undergoing intertrochanteric fracture fixation, aged 62 to 78 years old were randomly divided into two groups： ketorolac tromethamine treatment group （T） was given ketorolac tromethamine injection（60 mg） dissolved in saline （100 ml）, flurbiprofen treatment group （F） was given flurbiprofen injection （100 mg） dissolved in saline （100 ml）, during the analgesic effect are not best then intravenous administration. Using pain visual analogue scale （VAS） to evaluate patients＇ pain relief at time points after administration 30 min, 1,4, 8, 12, 24 h, the Ramsay sedation score was used to assess sedative effects of drugs at different time points and record adverse reactions in patients after treatment for postoperative analgesia and patient overall satisfaction. Results The VAS score was significantly higher in group F than that in the group T at 8,12h（p 〈0. 05）. At 4, 8, 12 h postoperative, T group scored lower on Ramsay than in group F, differences were statistically significant （p 〈 0. 05 ） , Postoperative incidence of adverse reactions in group T were less than in group F, The patient＇s overall analgesia satisfaction in group T is also higher. Conclusion Both drugs can be used in the elderly intertrochanteric fracture postoperative analgesia, while ketorolac tromethamine because of its good anal- gesic effect, a lower incidence of adverse reactions, higher patient satisfaction are better suited such crowd.