术前使用帕瑞昔布钠对硬膜外血肿患者围术期疼痛及凝血功能的影响

Effects of preoperative use of parecoxib sodium on perioperative pain and coagulation in patients with epidural hematoma

目的 探讨术前使用帕瑞昔布钠对硬膜外血肿患者围术期疼痛及凝血功能的影响.方法 选择脑外伤硬膜外血肿行手术治疗患者80例,采用随机数字表法分为两组,每组40例.术前30 min,观察组给予帕瑞昔布钠,对照组则使用相同剂量0.9％氯化钠注射液,比较术后6 h、12 h、24 h及48 h两组疼痛视觉模拟评分（VAS评分）变化情况,统计术后48 h内两组患者静脉自控镇痛（PCIA）按压次数,观察术后两组患者凝血功能变化情况.结果 观察组术后6 h、12 h、24 h及48 h疼痛VAS评分分别为（4.1±0.3）分、（4.0±0.2）分、（3.0±0.3）分和（2.3±0.1）分,均显著低于同时间点对照组（t=17.541、3.508、7.589、28.284,均P〈0.05）,观察组术后6 h、12 h、24 h及48 h PCIA按压次数分别为（1.9±0.4）次、（1.8±0.3）次、（1.1±0.2）次和（0.7±0.1）次,均少于对照组（t=4.939、3.795、12.279、16.000,均P〈0.05）,干预后两组凝血功能检查指标中PT、TT、APTT及Fib等差异均无统计学意义（t=0.407、0.000、1.491、0.331,均P〉0.05）.结论 术前使用帕瑞昔布钠能有效减轻硬膜外血肿患者围术期疼痛,且对凝血功能无影响.

Objective To investigate the effect of preoperative use of paracetin sodium on epidural pain and coagulation in patients with epidural hematoma. Methods 80 brain trauma patients with epidural hematoma underwent surgery were selected,and they were randomly divided into two groups according to the digital table,40cases in each group. 30min before surgery, the observation group was given parecoxib sodium, and the control group was treated with the same volume of 0.9% saline. Then, the changes of the visual analogue scale （VAS score） and PCIA compression times were compared between the two groups at 6h, 12h,24h and 48h after operation. The coagulation changes were observed. Results 6h, 12h,24h and 48h after operation, the VAS scores of the pain in the observation group were （4.1 ± 0.3 ） points, （4.0 ± 0.2 ） points, （ 3.0 ± 0.3 ） points and （ 2.3 ± 0.3 ） points, respectively, which were lower than those in the control group （t = 17.541,3.508,7. 589 and 28. 284, all P 〈 0. 05 ）. 6h, 12h ,24h and 48h after operation, the PCIA times in the observation group were （ 1,9 ± 0.4） times, （ 1.8± 0.3 ） times, （ 1.1 ± 0.2 ） times and （0.7 ±0.1 ） times, respectively, which were lower than those in the control group （ t = 4.939,3. 795,12.279 and 16.000, all P 〈 0.05 ）. The PT, TT, APTT and Fib between the two groups had no statistically significant differences （ t = 0.407, 0.000,1. 491 and 0. 331, all P 〉 0.05 ）. Conclusion Preoperative use of parecoxib sodium can effectively reduce the porioperative pain in patients with epidural hematoma, and it has no effect on coagulation function with high safety.