氟比洛芬酯联合舒芬太尼用于经皮肾镜钬激光碎石术47例

Postoperative Analgesia of Flurbiprofen Combined with Sufentanil for Percutaneous Nephroscope Holmium Laser Lithotripsy

目的探究氟比洛芬酯与舒芬太尼联用对于经皮肾镜钬激光碎石术后镇痛的临床效果。方法选取2015年6月—2016年6月于西安交通大学第一附属医院接受治疗的94例患者,随机分为治疗组和对照组,每组各47例。其中对照组采用舒芬太尼,治疗组采用氟比洛芬酯联合舒芬太尼。于治疗前后测定两组患者C反应蛋白(CRP)、白细胞介素(IL)-6水平,并对所有患者进行镇痛评分,以比较两组疗效差异。并统计两组治疗期间不良反应以评价氟比洛芬酯在经皮肾镜钬激光碎石术后镇痛中的价值。结果手术完成后分别于0,4,12,24,48 h对两组患者进行镇痛强度评分发现,0和48 h时两组数据差异无统计学意义(P>0.05),4,12,24 h时治疗组评分明显低于对照组,两组数据差异有统计学意义(t=3.411,5.606,3.767,P<0.05)。采取镇痛措施后,两组炎症因子水平均有一定程度降低,且治疗组降低更为明显,差异有统计学意义(t=3.957,3.793,P<0.05)。两组均有不良反应发生,治疗组不良反应发生率为6.38%,对照组不良反应发生率为8.51%,差异无统计学意义(P>0.05)。治疗组镇痛满意度为80.85%,明显高于对照组的57.45%,差异有统计学意义(χ2=6.034,P=0.014)。结论氟比洛芬酯与舒芬太尼联用较单独使用舒芬太尼对经皮肾镜钬激光碎石术后镇痛效果更好,可有效改善炎症因子水平,安全性较高,具有一定的临床应用价值。

Objective To explore postoperative analgesia effect of flurbiprofen combined with sufentanil in patients after percutaneous nephrolithotripsy with holmium laser.Methods Data were reviewed retrospectively from the first affiliated hospital of Xi'an jiao tong university between June 2015 and June 2016,in which patients were divided into two groups:treatment group(flurbiprofen combined with sufentanil)and control group(sufentanil)(n=47 in each group).Levels of CRP and IL-6 were detected before and after the treatment.Analgesic scores were compared between the two groups.Adverse reactions of the two groups during the treatment were recorded to evaluate postoperative analgesia effect of flurbiprofen in patients after percutaneous holmium laser lithotripsy.Results Analgesic scores of the two groups 0,4,12,24 and 48 h after the surgery were recorded.The scores at 0 and 48 h had no significant difference(P>0.05).Analgestic scores of the treatment group were significantly lower than those of the control group at 4,12 and 24 h(t=3.411,5.606,3.767,P<0.05).After taking analgesic measures,the levels of inflammatory factors of the two groups were all decreased.And the changes of the treatment group was more significant(P<0.05).Adverse reactions occurred in both groups.The incidence of adverse reactions in the treatment group(6.38%)was lower than that of the control group(8.51%)(P>0.05).The analgesic satisfaction rate of the treatment group was 80.85%,significantly higher than that of the other group(57.45%)(χ2=6.034,P=0.014).Conclusion As compared with sufentanil alone,flurbiprofen combined with sufentanil was more effective in postoperative analgesia in patients after percutaneous nephrolithotripsy with holmium laser.The combination can decrease the levels of inflammatory factors with better safety profile and value of clinical application.