氢吗啡酮复合氟比洛芬酯在剖宫产术后PCIA的应用

APPLICATION OF HYDROMORPHONE COMBINED FLURBIPROFEN AXETIL IN PCIA AFTER CAESAREAN SECTION

目的:观察氢吗啡酮复合氟比洛芬酯用于剖宫产术后静脉自控镇痛(PCIA)的临床效果。方法:剖宫产手术产妇90例随机分为3组,每组30例。三组术后自控镇痛的配方(均用生理盐水稀释至150ml):F组,芬太尼1.0mg+托烷司琼10mg;H组,氢吗啡酮4mg+托烷司琼10mg;KH组,氢吗啡酮3mg+氟比洛芬酯50mg+托烷司琼10mg。分别记录各组患者术后1h、3h、6h、10h、24h的镇痛泵有效按压次数、VAS疼痛评分、Ramsay镇静评分以及恶心呕吐、呼吸抑制、皮肤瘙痒、消化道出血、嗜睡等不良反应的发生情况,镇痛结束时对患者情绪进行评估。结果:KH组术后24h PCIA按压次数和各时间点VAS评分均明显低于F组和H组(P<0.05);三组不良反应发生情况和Ramsay评分比较差异无统计学意义(P>0.05);KH组术后TMD评分明显低于术前,且明显低于F组术后(P<0.05)。结论:氢吗啡酮复合氟比洛芬酯用于剖宫产术后静脉自控镇痛效果好,是一种安全有效的镇痛方法。

Objective：To observe the clinical effects of hydromorphone combined fluibiprofen axetil in patient-controlled intravenous analgesia（PCIA） after caesarean section.Methods：90 cases parturient with caesarean section were randomly divided into 3 groups with 30 parturients in each group.The formula of 3 groups：group F,fentanyl 1.0mg ＋tropisetron 10 mg in 150 ml 0.9%NaCl;group H,hydromorphone 4mg ＋ tropisetron lOmg in 150 ml 0.9%NaCl;Group KH,hydromorphone3mg＋flurbiprofen axetil 50mg＋tropisetron lOmg in 150 ml 0.9%NaCl.The effective pressing numbers,VAS score and Ramsay score 1h,3h,6h,10 h,24h after operation were respectively recorded;as well as the incidence of adverse reactions were observed.The patients＇ mood was evaluated at the end of analgesia.Results：The effective pressing numbers 24 h after operation and VAS score at each time point of patients in group KH were obviously lower than group F and group H（P〈0.05）.There was no significant difference about incidence of adverse reactions and Ramsay score between the 3 groups（P〈0.05）.The TMD score of group KH after operation were obviously lower than that before operation;moreover,it was obviously lower than group F after operation（P〈0.05）.Conclusions：Hydromorphone combined flurbiprofen axetil is a safe and effective analgesic method for PCIA after cesarean section.