加巴喷丁联合糖皮质激素对开腹子宫全切患者术后早期恢复影响研究

Effect of application of Gabapentin combined with glucocorticoid on early recovery of laparotomy total hysterectomy patients

目的:探讨术前药物干预(加巴喷丁、糖皮质激素)对妇科开腹子宫全切患者术后早期恢复的影响。方法:选取妇科住院接受开腹子宫全切术治疗的患者共计50例,所有患者按照快速康复外科(FTS)治疗模式,在围手术期给予FTS干预,实验组患者(n=25)在术前2h给予口服巴喷丁及糖皮质激素;对照组患者(n=25)术前2h给予口服安慰剂药物;分别记录两组患者术后1、6、12、24h视觉模拟评分法(VAS)数值,及术后首次按压PCIA泵给药时间和术后静脉自控镇痛(PCIA)药物24h的累积使用量;应用15项术后恢复质量问卷调查表(QoR-15),记录两组患者不良反应及并发症等项目评分。对比分析术前药物干预对患者术后早期恢复的影响程度。结果:实验组患者术后1、6h,VAS评分低于对照组(P<0.05);实验组患者术后首次按压PCIA泵给药时间以及PCIA药物24h的累积使用量低于对照组(P<0.05);实验组患者术后24、48h,QoR-15量表评分高于对照组(P<0.05)。结论:术前加巴喷丁及糖皮质激素的联合应用干预,可降低妇科开腹子宫全切患者术后疼痛及术后镇痛药物的使用量,提高患者术后早期恢复的质量,进一步加强术后快速康复治疗模式的实施效果。

Objective:To investigate the effect of application of Gabapentin combined with glucocorticoid on early recovery of laparotomy total hysterectomy patients.Methods:This study was a prospective randomized controlled tria1.50 laparotomy total hysterectomy patients were involved and randomly divided into experimental group(n=25)and control group(n=25).All patients were given FTS(Fast-track surgery,FTS)intervention during perioperative period.Patients in the experimental group were given taking orally with Gabapentin and glucocorticoid at 2h before surgery;Patients in the control group were given taking orally with placebo at the same time.After surgery 1,6,12,24 h to record Visual Analogue Scale of the two groups;To record the first use time of PCIA and the 24 h cumulative usage amount of PCIA drugs of each groups;To record the adverse effects and complications of the two groups by using QoR-15(15-item Quality of Recovery,QoR-15);To analyze the effect of preoperative drug intervention on the early recovery of patients.Results:Compared with the control group,the VAS after surgery 1h,6h of experimental group were lower than the control group,and the differences were statistically significant(P<0.05);The first use time of PCIA and the 24 h cumulative usage amount of PCIA drugs of the experimental group were lower(P<0.05);The QoR-15 score after surgery 24,48 h of experimental group were higher than the control group(P<0.05),and all the differences were statistically significant.Conclusion:Application of Gabapentin combined with glucocorticoid could reduce the postoperative pain and the usage amount of PCIA drugs of laparotomy total hysterectomy patients,as well as the quality of early recovery and further strengthen the effect of implementation of FTS.