噴他佐辛在混合痔术中的临床应用观察2.docVIP

喷他佐辛超前镇痛在吻合器痔上粘膜环切术中的应用 汤国辉 伍洲颂 刘丽兵 邓秋林 邢佼涛 南华大学附属南华医院肛肠外科（湖南 衡阳 421002） 摘要 目的方法结果恶心呕吐、头晕两组比较差异无统计学意义。结论 Tang Guo-hui, Zhou-Song Wu, Li-Bing Liu,Qiu-lin DENG ,Jiao-Tao Xing , Colorectal Surgery, the Affiliated Nanhua Hospital of the Nanhua University,Hengyang,,Hunan Province, China,421002 [Abstract] Objective: To explore the analgesic effect of Application of pentazocine with Yaoshu acupoints anesthesia in PPH. Methods: 100 patients performed PPH were randomly divided into experimental group and control group, with 50 patients in each group. About 10 minutes before the operation,Pentazocine 30mg Im in the experimental group.then aline 2ml Im in the control group .The two groups of the anaesthesia are Yaoyu acupoints.Before and after PPH were observed, and the pain, force reflection and adverse reactions of two groups were also observed.The VAS scores in the 2 ,6 and 8 hours after PPH were also observed. Results: The VAS scores of experimental group during the three times was lighter than that of control group and the effective rate of inhibiting force reflection was higher than that of control group .The adverse reaction rate was no better than that of control group . Conclusion: Pentazocine with Yaoyu acupoints anesthesia in PPH is safe and effective, the force reflection is slight and better than single Yaoyu.Pentazocine with Yaoyu acupoints anesthesia in PPH , thus it is worthy of application in clinic. [Key words] Pentazocine; Preemptive analgesia; Procedure for prolapse and hemorrhoids 喷他佐辛（pentazocine，PTZ）是一种新的阿片受体激动-拮抗药物，选择性地激动 κ 受体，具有良好的镇痛效应，且不良反应比吗啡少，已广泛用于术后镇痛，但其在围术期超前 镇痛的应用鲜见报道。 吻合器痔上黏膜环切钉合术(PPH)是一种利用吻合器环形切除治疗Ⅲ、Ⅳ期内痔为主的混合痔或环形内痔的重要方法 因其手术时间短 创伤小而广受欢迎 ,本文观察喷他佐辛超前镇痛对PPH患者术中牵拉反应的抑制效果和术后镇痛效果的影响， 以期指导临床。 1、材料和方法 1.1材料 按随机兼顾均衡的原则,将2013-09/2014-01住院的混合痔行PPH手术的患者，符合纳入标准者签署知情同意书后，分为治疗组(喷他佐辛组)和对照组 (生理盐水组)。共纳入100例，试验组50例，对照组50例。两组治疗前比较及总体统计比较显示在性别、年龄、病程和病情等方面差异均无统计学意义(P0.05),具有可比性（表1）。 表1 两组患者术前一般情况比较总表 组别 性别（例） 平均年龄 （岁） 平均病程 （年） 内痔分期（例） 外痔分类（例） 男 女