曲马朵复合安痛定用于痔切除术后镇痛效果观察.DOCVIP

临床医学论文-曲马朵复合安痛定用于痔切除术后镇痛效果观察 ????????? 作者：李继元，娄海东，宋学民 【摘要】? 目的 观察曲马朵复合安痛定用于痔切除术后镇痛的有效性和安全性。方法 将病人60例随机分为观察组30例，对照组30例，观察组术后2 h 给予曲马朵50 mg+安痛定2 ml 肌内注射，对照组术后采用常规哌替啶50 mg 肌内注射。术后16 h 各追加肌注1次。观察两组病人术后6，12，24，36，48 h 的视觉模拟评分(VAS)及恶心、呕吐和呼吸抑制等不良反应情况。结果 两组病人VAS评分差异无显著意义(P0．05)，均可取得满意镇痛效果，两组无明显呼吸抑制，观察组恶心、呕吐的发生率为17%，而对照组恶心、呕吐发生率为10%，两组不良反应差异无显著意义(P0．05)。结论 曲马朵复合安痛定用于痔切除术术后镇痛疗效确切，安全性好，是一种相对更安全、有效的术后镇痛方法。 【关键词】? 曲马朵；安痛定；术后镇痛 　　Observation of Analgetic Effectiveness of Tramadol plus Antondin after Hemorrhoidectomy 　　Abstract： Objective? To observe the analgetic effectiveness of tramadol plus antondin after hemorrhoidectomy and its safety. Methods? Sixty patients were averagely divided into observation group and control group at random. The observation group was administered tramadol (50 mg) plus antondin (2 ml) by intramuscular injection two hours later after hemorrhoidectomy, and the control group with pethidine (50 mg). Both the two groups were given another supplementary injection 16 hours later hemorrhoidectomy. All the patients were observed on the aspect of visual analogue scale (VAS) at the sixth, the 12th, th 24th and the 48th hour after operation, and were observed on the aspect of side effects such as nausea and vomittting. Results牋 There was no significant difference in VAS between the two groups (P0.05) in addition to satisfactory analgetic effectiveness. No respiratory inhibition occurred in any of the groups. Moreover, the side effect incidence of the observation group was 17%, which was not significantly different from that (10%) of the control group (P0.05). Conclusion?The application of tramadol plus antondin to the analgesia after hemorrhoidectomy brings about definitely effective outcome with good safety. 　　Key? words： tramadol; antondin; postoperative analgesia ??? 痔切除术，常因创伤较大及粪便刺激伤口引起疼痛，加之肛门局部神经敏感、血管丰富，易导致并加重便秘和排便困难等症状，影响病人术后的生活质量和创伤的愈合，往往术后需要多次镇痛。目前临床上多采用哌替啶术后镇痛，但易成瘾。2003年12月—2005年12月，我们将曲马朵复合安痛定与哌替啶进行比较，疗效满意。 　　1? 资料和方法 　　1．1? 对象和分组? 　　本组60例中，随机分为观察组和对