口服美洛昔康对腹腔镜胆囊切除术镇痛效果_临床医学论文.docVIP

口服美洛昔康对腹腔镜胆囊切除术镇痛效果_临床医学论文 口服美洛昔康对腹腔镜胆囊切除术镇痛效果_临床医学论文 作者：孙建娣,任传路,水祥兵 【摘要】 目的：研究美洛昔康超前镇痛对腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)患者疼痛的影响。方法：选取60例ASA Ⅰ～Ⅱ级择期LC患者，随机分为实验组和对照组，每组30例。实验组于术前20～22h，4～6h及术后6h各口服1片7.5mg美洛昔康;对照组不服用美洛昔康。使用视学模拟评分法(VAS)评定并比较两组患者术后疼痛程度，比较两组下床活动时间并观察不良反应。结果：实验组术毕即刻及术后2、4、8、12h VAS评分在同一时间点均显著低于对照组(0.01)，实验组下床活动时间也明显短于对照组(0.01)，两组患者术后不良反应发生率差异无统计学意义(Pgt;0.05)。结论：术前后口服美洛昔康能有效地解除LC术后疼痛。 【关键词】 美洛昔康;超前镇痛;腹腔镜胆囊切除术 　　[ABSTRACT] Objective: To observe analgesia effects of oral admistration of meloxicam in laparoscopic cholecystectomy. Methods: Sixty patients that were scheduled for laparoscopic cholecystectomy were randomly divided into experimental group and control group with 30 cases in each. The experimental group was given an extra piece of meloxicam (7.5 mg) 2022 h, 46 h before and 46 h after operation. Analysis of visual analogue scale (VAS) was used for pain evaluation at five time points including the end of LC, 2 h, 4 h, 8 h, 12 h after the operation, start of offbed activity and adverse drug reactions were observed and compared between the two groups. Results: VAS scores of experimental group at all five time points were significantly lower than that of the control group (0.01), so was the offbed activity time (0.01); but no significant difference was found in adverse drug reactions (Pgt;0.05). Conclusions: Oral admistration of meloxicam shows good analgesia effects in patients that underwent laparoscopic cholecystectomy. 　　[KEY WORDS] Meloxicam; Preemitive analgesia; Laparoscopic cholecystectomy 　　腹腔镜胆囊切除术(laparoscopic cholecystectomy , LC)创伤小，术后恢复快,被广泛应用于临床。但术后疼痛，尤其是24h内疼痛仍然是影响患者住院时间及手术满意度的重要因素，有必要进行干预治疗[1]。本文观察了倾向性环氧酶(COX2)抑制剂美洛昔康在LC术后的镇痛效果。 　　1 资料与方法 　　1.1 一般资料 　　选择美国麻醉医师学会(American Society of Anesthesiologists, ASA )Ⅰ～Ⅱ级择期 LC 的患者 60 例，其中男性32 例，女性 28例，年龄 24～68岁，体重 45～78kg。经患者同意，随机分为实验组(30例)和对照组(30例)。实验组分别于术前20～22h，4～6h及术后6h各口服1片7.5mg美洛昔康(奈邦，江苏亚邦爱普森药业);对照组不服用美洛昔康。两组手术时间均不超过45min。两组患者性别、年龄、身高、体重、ASA 分级、手术时间等一般情况差异无统计学意义(Pgt;0.05),具有可比性。