文章摘要
张家泉,李旺勇,孙杰,等.独一味联合地佐辛镇痛治疗对老年胆总管结石病人术后疼痛的影响[J].安徽医药,2022,26(10):2094-2097.
独一味联合地佐辛镇痛治疗对老年胆总管结石病人术后疼痛的影响
Effect of Duyiwei combined with dezocine on postoperative pain in elderly patients with choledocholithiasis
  
DOI:10.3969/j.issn.1009-6469.2022.10.043
中文关键词: 镇痛药  疼痛,手术后  独一味胶囊  地佐辛  胆总管造口术  胆总管结石病  中西医结合
英文关键词: Analgesics  Pain, postoperative  Duyiwei capsules  Dezocine  Choledochostomy  Choledocholithiasis  Inte. grated Chinese and Western medicine
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作者单位E-mail
张家泉 蚌埠医学院第四附属医院淮南市第一人民医院普外科安徽淮南 232007  
李旺勇 蚌埠医学院第四附属医院淮南市第一人民医院普外科安徽淮南 232007  
孙杰 蚌埠医学院第四附属医院淮南市第一人民医院普外科安徽淮南 232007  
冯其柱 蚌埠医学院第四附属医院淮南市第一人民医院普外科安徽淮南 232007  
王琦 蚌埠医学院第四附属医院淮南市第一人民医院普外科安徽淮南 232007 wangqihn727@163.com 
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中文摘要:
      目的研究独一味联合地佐辛镇痛对老年胆总管结石病人术后的影响。方法选取淮南市第一人民医院 2017年 6月至 2020年 5月收治的年龄 ≥60岁的 102例胆总管结石的病人,随机数字表法分为两组,对照组 51例,术后给予 0.25%地佐辛、阿扎司琼 0.08 mg/mL行自控镇痛,负荷量 2 mL,以 2 mL/h为背景剂量持续泵入,单次剂量 2 mL,锁定时间 20 min。研究组 51例,在对照组基础上口服独一味胶囊, 3粒/次, 3次/天,连服 7d。比较两组术后 1d、2d、3d数字分级法疼痛( NRS)评分,术后 72 h静脉补救镇痛次数,镇痛泵( PCA泵)泵压次数,呕吐、头晕、切口出血发生率,病人镇痛效果满意度,血清皮质醇、醛固酮及 C反应蛋白( CRP)含量。结果通过独立样本 t检验和 χ2检验分析,研究组术后 1d[( 3.92±0.90)分比( 5.49±4.68)分]、 2d[( 3.37±
英文摘要:
      Objective To study the effect of Duyiwei combined with dezocine analgesia on elderly patients with choledocholithiasis after surgery.Methods A total of 102 patients with choledocholithiasis aged ≥60 years who were admitted to Huainan First People'sHospital from June 2017 to May 2020 were selected and randomly divided into two groups. The control group of 51 cases was givendezocine (0.25%) and azasetron (0.08 mg/mL) for patient-controlled analgesia after operation, with a loading volume of 2 mL, continu.ously pumped at a background dose of 2 mL/h, a single dose of 2 mL, and a lock-in time of 20 min. The 51 cases in the study group were given Duyiwei capsules on the basis of the control group, 3 capsules/time, 3 times/day, for 7 days. Comparing the two groups after1 d, 2 d and 3 d, the digital grading pain (NRS) scores, the times of intravenous rescue analgesia at 72 h after operation, the analgesicpump (patient-controlled analgesia, PCA) pumping times, the incidence of vomiting, dizziness, and incision bleeding, the patient satis.faction with analgesia effects, serum cortisol, aldosterone and C reactive protein (CRP) levels were compared between the two groups.Results Through independent samples t test and χ2 test analysis, the NRS pain scores at 1 d [(3.92±0.90) score vs. (5.49±4.68) score], 2 d [(3.37±1.13) score vs. (4.01±1.30) score] and 3 d [(3.09±1.20) score vs. (3.98±1.60) score ] in the study group were significantly low. er than those in the control group (P < 0.05). The number of intravenous rescue analgesia administrations at 72 hours after surgery inthe study group was 4 times, which was lower than the 11 times in the control group. The time of PCA pumping in the study group was12 times, which was lower than the 20 times in the control group. The analgesic effect satisfaction score of the patients in the studygroup [(4.37±0.77) points vs. (3.10±0.72) points] was significantly higher than that in the control group, and the difference was statisti. cally significant (P < 0.05). The levels of serum cortisol [(417.65±13.56) nmol/L vs. (464.98±19.01) nmol/L], aldosterone [(0.22±0.01) μg/L vs. (0.27±0.01) μg/L] and CRP [(102.20±11.83) mg/L vs. (104.26±12.67) mg/L] in the study group were significantly lower thanthose in the control group, and the difference was statistically significant (P < 0.05).Conclusion The use of Duyiwei combined with dezocine analgesia for elderly patients after open choledocholithotomy has a definite analgesic effect, which can increase patient satis.faction, improve postoperative stress and the inflammatory response, and has clinical application value.
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