帕瑞昔布钠对乳腺癌根治术患者舒芬太尼自控静脉镇痛效果影响.docVIP

帕瑞昔布钠对乳腺癌根治术患者舒芬太尼自控静脉镇痛效果影响 　　 摘 要 目的：探究帕瑞昔布钠在乳腺癌根治术患者的舒芬太尼自控静脉镇痛中的临床应用价值。方法：采用前瞻性开放研究，收治拟行乳癌根治术的患者80例，随机分为两组，分别用帕瑞昔布钠和安慰剂进行治疗，比较两组的情况。结果：分别比较两组术后2、12、24小时的VAS评分及Ramsay评分，2及12小时VAS差异有统计学意义(t?1=16.76，t?2=3.82，P＜0.05)；术后2小时Ramsay评分差异有统计学意义(t=8.36，P＜0.05)。结论：将帕瑞昔布钠应用于乳腺癌根治术患者的舒芬太尼自控静脉镇痛过程中，可以提高镇静、镇痛的质量，效果满意，因此其应用面将会越来越广。? 　　关键词 乳腺癌根治术 帕瑞昔布钠 舒芬太尼 自控静脉镇痛? 　　doi:10.3969/j.issn.1007-614x.2012.03.124?? 　　Abstract Objective:To investigate the clinical significance of parecoxib on sufentanil self-controlled vein analgesic effect in Breast cancer patients after radical mastectomy.Methods:With the prospective open study,80 breast cancer patients who would accepted radical mastectomy were collected from January 2009 to February 2011 in our hospital,and put them into two groups as study group and control group randomly,respectively for parecoxib and placebo treatment,compared the difference between the two groups.Results:The two groups were compared with the VAS score and the Ramsay score of 2 hours,12 hours,and 24 hours after radical mastectomy.There were significant differences between two group in two hours and 12 hours of the VAS (t?1=3.82,t?2=16.76,P＜0.05);And were significant differences in two hours of Ramsay score(t=8.36,P＜0.05).Conclusion:It show parecoxib obvious advantages in applying sufentanil self-controlled vein analgesic effect which is worthy of clinical promotion or can be recognized as a prior choice.? 　　Key Words The radical mastectomy of breast cancer;Parecoxib;Sufentanil;Self-controlled vein analgesic?? 　　乳癌根治术已经成为目前临床上针对乳癌患者采取的常见的外科治疗手段，也是乳癌患者首选的治疗方案。根治术的切除范围较广，创伤面大，术后的疼痛给患者带来巨大的身体及心理压力。剧烈的疼痛可导致患者生理功能紊乱，引起失眠，甚至诱发休克而危及生命。因此，临床上在乳癌根治术中术后适当采用镇痛措施以缓解??者的剧痛是必要的，对患者的治疗和身体恢复有重要意义。随着医学的不断发展，目前多模式的镇痛方式已经应用于临床，但选择合适的镇痛药物成为多模式镇痛的研究方向。帕瑞昔布钠是一种环氧合酶-2(COX-2)特异性抑制剂，属于抗关节炎药中的昔布类镇痛药，是伐地昔布的前体药物。大量研究表明，COX-2作为环氧化酶异构体由前-炎症刺激诱导生成，因此可知，COX-2在与疼痛、炎症和发热有关的前列腺素样递质的合成过程中发挥最主要作用，用于乳腺癌根治术患者舒芬自控静脉镇痛中可取得满意的镇痛效果。2009年1月～2011年2月收治拟行乳癌根治术患者80例，随机分为两组，分别用帕瑞昔布钠和安慰剂进行治疗，比较两组的情况，进一步探究帕