局麻联合阿片类药物在经皮肾碎石术中的效果

Effect of Local Anesthesia Combined With Opioids in Percutaneous Nephrolithotomy

目的浅析实施标准通道经皮肾碎石术患者使用局部麻醉联合静脉镇痛与局部麻醉联合阿片类镇痛的效果差异性。方法2014年6月-2019年6月,有140名需要进行标准通道经皮肾碎石术的肾结石患者来医院进行诊治,按照科学的随机分配原则将这140名患者进行随机组合,分为静脉组与阿片组两组,其中静脉组患者共有83例,阿片组患者共有57例。两组患者采取的手术治疗方式具有一致性,但是在麻醉措施上存在明显差异,对比2组患者治疗后疼痛程度以及镇痛效果。结果对2组进行标准通道经皮肾碎石患者采取不同的麻醉措施,治疗前,两组患者身体各项基本指标不具有统计学意义(P>0.05),治疗后,静脉组患者身体指标变化幅度与阿片组身体指标变化幅度相比较,幅度变化较小,证明静脉组麻醉措施安全性较高,差异具有统计学意义(P<0.05);两组在住院时长、住院费用和结石清除率方面,差异具有统计学意义,P<0.05,静脉组患者的手术时长明显比阿片组长(P<0.05),但两组术中出血量比较无统计学意义,P>0.05。结论试验结果显示,对于标准通道经皮肾碎石术的肾结石患者,应用局麻联合静脉镇痛,可以明显降低危险性,并且镇痛等方面的效果显著。

Objective To analyze the difference in the effect of local anesthesia combined with intravenous analgesia and local anesthesia combined with opioid analgesia in patients undergoing standard channel percutaneous nephrolithotripsy.Methods From June 2014 to June 2019,140 patients with nephrolithiasis who need to undergo standard channel percutaneous nephrolithotripsy came to our hospital for diagnosis and treatment.According to the most scientific random distribution principle,these 140 patients were randomly combined and divided into two groups:intravenous group and opioid group.There were 83 patients in intravenous group and 57 patients in opioid group.The two groups of patients have the same surgical treatment,but there are significant differences in anesthesia measures.Compare the pain degree and analgesic effect of the two groups after treatment.Results Different anesthesia measures were taken for the two groups.Before the treatment,the basic body indexes of the two groups were not statistically significant(P>0.05).After the treatment,the change range of the body indexes in the vein group was smaller than that in the opioid group,which proved that the anesthesia measures in the vein group were safe the difference was statistically significant(P<0.05);the difference was statistically significant in length of stay,cost of stay and stone clearance rate between the two groups(P<0.05).The length of operation in the vein group was significantly longer than that in the opioid group(P<0.05),but there was no statistical significance in the amount of bleeding between the two groups(P>0.05).Conclusion The experimental results show that local anesthesia combined with intravenous analgesia can significantly reduce the risk of nephrolithotripsy,and the effect of analgesia is significant.