急诊科早期镇痛在严重多发伤中的疗效观察

Observation of curative effect of early analgesia treatment on severe multiple trauma in the emergency department

目的 探讨严重多发伤患者在急诊科早期进行镇痛治疗时不同镇痛药物的治疗效果与不良反应.方法 选取解放军第九八医院急诊科严重多发伤患者123例,采取随机数字表法分为盐酸哌替啶组40例、地佐辛组41例、酮咯酸氨丁三醇组42例.3组入院时分别肌内注射盐酸哌替啶注射液75 mg、地佐辛注射液7.5 mg、酮咯酸氨丁三醇注射液60 mg.观察比较3组镇痛效果和不良反应.结果 3组镇痛总有效率均为100％,差异无统计学意义（P＞0.05）.地佐辛组和酮咯酸氨丁三醇组的总不良反应发生率[14.6％ （6/41）,9.5％ （4/42）]明显低于盐酸哌替啶组（75.0％,30/40）,组间比较差异有统计学意义（P＜0.05）.结论 严重多发伤患者在急诊科早期进行镇痛治疗可获得满意的疗效.在镇痛药选择上应首选镇痛作用强、不良反应低的地佐辛,其次是酮咯酸氨丁三醇,应减少盐酸哌替啶等阿片类镇痛药物的使用.

Objective To evaluate the effect of early analgesia treatment on severe multiple trauma in the emergency department.Methods Totally 123 patients with severe multiple trauma were randomly divided into hydrochloride pethidine group （40 cases）,dezocine group （41 cases） and ketorolac tromethamine group （42 cases）.Three groups were given hydrochloride pethidine injection 75 mg,dezocine injection 7.5 mg and ketorolac tromethamine 60 mg respectively.Analgesic effect and adverse reactions of three groups were observed.Results The total analgesic rate was 100% ; there was no statistically significant difference （P 〉 0.05）.The total rate of adverse reaction of dezocine group and ketorolac tromethamine group were obviously less than that of hydrochloride pethidine group （14.6%,9.5% vs 75.0%） ; the difference was statistically significant （P 〈 0.05）.Conclusions The early analgesia treatment can obtain satisfactory curative effect for severe multiple injuries in the emergency department.Low adverse reaction of dezocine ketorolac tromethamine and dezocine should reduce the use of opioids such as pethidine hydrochloride.