静脉帕瑞昔布钠复合吗啡自控镇痛对肺叶切除术患者术后疼痛及呼吸功能的影响

Effects of patients controlled analgesia with morphine and intravenous parecoxib on postoperative pain and respiratory function in patients after pulmonary Iobectomy

目的观察静脉帕瑞昔布钠复合吗啡自控镇痛（PCA）对肺叶切除术患者术后疼痛及呼吸功能的影响。方法肺癌行肺叶切除术患者40例，随机分成联合组和吗啡组，每组20例。两组患者术后均采用吗啡PCA泵自控镇痛，于术后12、24、36h时联合组患者另分别静脉注射帕瑞昔布钠40mg。记录两组患者各时点VAS评分、术后不良反应及用力肺活量（FVC）和肺弥散度。结果术后各时点，联合组患者安静痛、咳嗽痛评分，PaCO2及不良反应均低于吗啡组患者（P〈0．05）；联合组患者FVC、第1秒用力呼气量（FEV1）和FEV1／FVC值均高于吗啡组，而PaCO2低于吗啡组，差异有统计学意义（P〈O．05）。结论帕瑞昔布钠复合吗啡术后自控镇痛应用于肺叶切除术患者，可更好地缓解患者的疼痛，减少不良反应，且有利于患者的肺功能恢复。

Objective To observe the effects of patients controlled analgesia （PCA） with morphine combined with intravenous parecoxib sodium on postoperative pain and respiratory function in patients after pulmonary lobectomy. Methods Forty patients undergoing pulmonary lobectomy were randomly divided into combined group and morphine group, 20 cases in each group. All patients in the two groups were received PCA with morphine. Patients were additionally injected parecoxib sodium 40 mg at 12, 24, 36 hs after the operation in the combined group. VAS, postoperative adverse reactions, forced vital capacity （FVC） and FEV1 were observed postoperatively. Results At each time point after operation, VAS at rest and coughing, PaCO2 and complications in the combined group were significantly lower than those in the morphine group （P〈0.05）. FVC, FEV1 and FEV1/ FVC in the combined group were significantly higher than those in the morphine group （P〈0.05）. Conclusion PCA with morphine and intravenous parecoxib sodium analgesia can effectively relieve pain, reduce adverse reactions, and promote the pulmonary function recovery in patients after pulmonary lobectomy.