不同镇痛方式对开胸手术患者术后谵妄发生率的影响

The influence of different analgesia methods on the incidence of delirium in patients undergoing thoracic surgery

目的:研究探讨不同镇痛方式对开胸手术患者术后谵妄发生率的影响,总结容易引发术后患者谵妄的因素。方法:将开胸手术的93例患者按照实验分组随机的原则分成三组,A组采用舒芬太尼+布托啡诺镇痛,B组采用舒芬太尼+布托啡诺+托烷司琼镇痛,C组采用舒芬太尼+布托啡诺+托烷司琼+氟哌利多镇痛。结果:三组手术时间、出血量、输血量等资料比较,差异无统计学意义(P>0.05);但术后疼痛数字评分(VAS)以及术后呕吐发生率C组显著低于A组与B组(P<0.05);C组谵妄发生率非常显著低于B组与C组(P<0.01);B组谵妄发生率显著低于A组(P<0.05)。结论:C组患者发生谵妄率最低,临床效果显著。

Objective：To study the different analgesia for patients undergoing thoracic surgery after the occurrence of de-lirium rate effect,sums up the factors of postoperative patients with delirium. Methods：Underwent open chest surgery in 93 pa-tients divided into three groups,which group A by sufentanil combined with butorphanol analgesia,group B with sufentanil com-bined with butorphanol and supporting tropisetron analgesia,group C with sufentanil alliance with butorphanol and supporting alkyl our Joan and droperidol bullish analgesia. Results：The 3 groups in operation time,bleeding volume,blood transfusion vol-ume data have no significant difference（P ﹥ 0. 05）;but the postoperative pain score（VAS）and postoperative vomiting rate of group C was higher than that of group A and group B（P 〈 0. 05）. Group C the incidence of delirium is significantly than that in group B and group C（P 〈 0. 01）. Group B delirium occurrence rate was superior to that of group A（P 〈 0. 05）. Conclusion：Using sufentanil alliance with butorphanol and supporting the incidence of tropisetron and droperidol for analgesia in the group C patients with delirium was minimum,and the clinical effect is significant.