地佐辛、布托啡诺复合高乌甲素用于贲门癌术后镇痛

The clinical effects of dezocine, butorphanol composite lappaconitine on postoperative analgesia for gastriccardia cancer

目的对比分析地佐辛、布托啡诺复合高乌甲素应用于贲门癌术后静脉自控镇痛（PCIA）的效果。方法选择择期贲门癌手术患者150例为研究对象，按照随机数字表法将其分为三组，A组50例患者术后采用高乌甲素镇痛泵，B组50例患者术后采用布托啡诺复合高乌甲素，C组50例患者术后采用地佐辛复合高乌甲素，采用疼痛视觉模拟评分（VAS）和Ramsay镇痛评级评估患者术后1h（T1）、3h（T2）、6h（13）、12h（T4）、24h（T5）、36h（T6）疼痛的程度以及镇痛效果，同时观察对比三组患者不良反应发生情况。结果各组患者在T1、T2、仍、T4、T5、T6等时间点VAS疼痛评分比较差异均无统计学意义（F=1．703，P=0．400；F=4．817，P=0．058；F=1．861，P=0．235；F=0．113，P=0．895；F=0．811，P=0．488；F=1．631，P=0．272）；Ramsay镇痛评级各时间点差异均无统计学意义（F=2．907，P=0．948；F=0．948，P=0．439；F=4．858，P=0．056；F=0．18，P=0．891；F=1．417，P=0．3313；F=4．582，P=0．053）；A组不良反应率为42．00％明显高于B组（4．00％）和c组（8．00％），差异有统计学意义（X2=20．38，P=0．000；x。=15．41，P=0．000）。结论地佐辛、布托啡诺复合高乌甲素应用于贲门癌患者术后镇痛效果显著，不良反应发生率低，安全性高。

Objective To compare the clinical effects of dezocine, butorphanol composite lappaconitine on patient controlled intravenous analgesia （PCIA） in postoperative surgical patients with gastric cardia cancer. Methods 150 patients received cardiac cancer surgery were randomly divided into three groups according to the random number method. 50 patients in A group were given lappaconitine analgesia pump postoperatively, 50 patients in B group were given butorphanol composite lappaconitine,50 patients in C group were given dezocine composite lappaconitine.Pain visual analogue scale（VAS） and Ramsay analgesia rating were used to evaluate the degree of pain and analgesic effect postoperative 1 h（T1） ,3 h（T2） ,6 h（T3） ,12 h（T4） ,24 h（TS） ,36 h（T6）. The adverse events were observed and compared. Results VAS score at T1, T2, T3, T4, TS, T6 had no statistically significant differences among three groups （F= 1.703,P=0.400;F=4.817,P =0.058;F= 1. 861,P =0.235;F =0. 113,P =0. 895;F =0. 811,P= 0. 488;F = 1. 631, P = 0. 272 ）. Ramsay score at each time point had no statistically significant differences （ F = 2. 907,P=0. 948;F=0.948,P=0. 439;F =4. 858,P =0.056;F =0.18,P =0. 891;F= 1. 417,P =0. 3313;F = 4. 582, P = 0. 053 ）. The incidence rate of adverse reaction in A group was 42.00% , which was higher than 4.00% in group B and 8.00% in group C ,the difference was statistically significant（ X2 = 20.38, P = 0. 000 ; X2 = 15.41, P = 0. 000）. Conclusion The postoperative analgesic effect of dezocine, butorphanol composite lappaconitine for gastric cardia cancer is remarkable, safe, and has low incidence rate of adverse reactions.