纳布啡超前镇痛对腹腔镜胆囊切除术患者术后镇痛及应激反应的影响效果观察

The Analgesia and Stress Reaction Effects of Nalbuphine Preemptive Analgesia in Laparoscopic Cholecystectomy Cholecystectomy

目的:观察纳布啡超前镇痛对腹腔镜胆囊切除术患者术后镇痛及应激反应的影响效果。方法:从2015年9月~2016年9月江西省鹰潭市中医院接受并予以腹腔镜胆囊切除术治疗的疾病患者中随机抽取50例作为研究对象,并将其分为参照组与实验组,均25例。参照组患者术前静脉注射氯化钠溶液,实验组患者则于术前静脉注射纳布啡,比较分析两组患者的镇痛效果、术后不同时间段(4h、8h、12h以及24h)视觉模拟评分(VAS)、舒适度评分(BCS),以及术前、术后两组患者血糖浓度(Glu)与皮质醇(Cor)变化情况。结果:实验组的总有效率为96.00%,参照组的总有效率为76.00%,相比实验组,参照组的镇痛效果比较显著,组间数值差异存在统计学意义(P<0.05);实验组患者术后4h、8h、12h、24h时间段VAS评分均明显低于参照组,BCS评分高于参照组,且P<0.05,差异具有统计学意义。术前,两组患者Glu、Cor差异较小,P>0.05;术后,两组患者Glu、Cor均有所下降,但实验组患者指标数值降低幅度优于参照组,数据存在显著统计学差异,P<0.05。结论:腹腔镜胆囊切除术术前实施纳布啡超前镇痛,可以起到明显的镇痛效果;可有效减轻术后痛疼、降低应激反应,非常值得在临床中大力推广使用。

Objective:To observe the effects of nalbuphine preemptive analgesia in laparoscopic cholecystectomy in patients with postoperative analgesic effects and stress response.Methods:50cases from September2015to September2016in our hospital accepted laparoscopic cholecystectomy were randomly selected as the research object,and divided into control group and experimental group,with25cases in each group.Control group patients received intravenous injection of sodium chloride solution,and the patients in the experimental group received intravenous injection of nalbuphine before the operations.The analgesic effect,pain intensity score(VAS)at different postoperative time(4h,8h,12h and24h),Shu Moderate(BCS)score,postoperative blood glucose concentration(Glu)and cortisol(Cor)in two groups of patients were observed and compared.Results:The total effective rate was96%in experimental group,which is higher than the control group with the total effective rate was76%(P<0.05);VAS scores were significantly lower in the experimental group at4h,8h,12h,24h after operation,compared with the control group;BCS score was higher in the experimental group compared with that of the control group(P<0.05).Before operation,there was no difference in Glu,Cor level between the two groups of patients,P>0.05;after the operation,Glu and Cor level were decreased in both of the two groups.However,the decreased level is higher in the experimental group than the reference group,with significant difference(P<0.05).Conclusions:Nalbuphine preemptive analgesia has obvious analgesic effect on patients with laparoscopic resection of gallbladder.It can effectively relieve postoperative pain,reduce the stress response,thus,it is worthy of promotion in clinical use.