地佐辛在内科胸腔镜检查中的应用

Application of dezocine in medical thoracoscopy

目的：观察地佐辛注射液在内科胸腔镜检查中的镇痛、镇静效果。方法选取不明原因胸腔积液患者98例，采用数字表法随机分为镇静组（加地佐辛）49例和麻醉组（只局部使用利多卡因）49例。镇静组于操作开始前静脉注射地佐辛5 mg，之后5 mg 加入0．9％氯化钠注射液100 mL 中持续静脉滴注，手术时2％利多卡因10 mL 进行局部麻醉；麻醉组只采用2％利多卡因10 mL 进行局部麻醉。记录两组患者口述评分法（VRS）及视觉模拟评分法（VAS）评分，以及两组患者血流动力学、胸膜反应的情况。结果镇静组、麻醉组 VAS 评分分别为（4．3±2．2）分、（2．1±1．9）分，VRS 评分分别为（3．5±1．1）分、（1．4±1．1）分，两组差异均有统计学意义（t ＝0．415，P ＝0．019；t ＝0．293，P ＝0．006）。两组胸腔镜操作时间差异无统计学意义，但镇静组在血流动力学指标如最大心率、收缩压、舒张压以及胸膜反应如咳嗽、头晕、胸闷、出汗等方面更稳定。结论地佐辛注射液用于内科胸腔镜检查治疗中，镇痛效果显著，不良反应较少，有效缓解胸腔镜检查带来的不适感，提高患者配合度及舒适感，提高检查成功率。

Objective To observe the analgesic and sedative effects of dezocine injection on the medical thoracoscopy check -up.Methods 98 cases of patients with unexplained pleural effusion were randomly divided into sedation group（dezocine group,49 cases）and anesthesia group（local anesthesia by lidocaine,49 cases）by adopting digital expression method.Sedation group was intravenously injected with 5mg dezocine before the operation,and another 5mg dezocine was mixed with 100mL of 0.9% sodium chloride for intravenous drip,with 10mL of 2%lidocaine for local anesthesia during the operation;anesthesia group was only administered with 10mL of 2% lidocaine for local anesthesia.Verbal rating scales（VRS）results and visual analogue scales（VAS）results of the two group patients,as well as their hemodynamics and pleural reaction were recorded.Results The VAS scores of the sedation group and anesthesia group were （4.3 ±2.2）points and （2.1 ±1.9）points,respectively,VRS scores were （3.5 ± 1.1）points and （1.4 ±1.1 ）points,there were statistically significant differences（t =0.415,P =0.019 and t =0.293,P =0.006,respectively）.The two groups had basically similar operation duration,but the sedation group had more stable hemodynamic indexes such as maximum heart rate,systolic pressure,diastolic pressure and pleural reaction,including cough,dizziness,chest tightness,sweating,etc.Conclusion Dezocine injection can be used in medical thoracoscopy check -up and treatment,with significant analgesic effect and less adverse reaction,effectively alleviating the discomfort of thoracoscopy check -up,and improving patients′compliance and comfort,so as to enhance the success rate of thoracoscopy check -up.