亚甲蓝在肛肠病术后镇痛应用临床研究.docVIP

亚甲蓝在肛肠病术后镇痛应用临床研究 　　[摘要] 目的：解决肛肠病术后疼痛问题。方法：以亚甲蓝为主，组成长效镇痛剂进行临床应用。观察镇痛治疗的满意度，生理指标，术后不良反应。结果：Ⅰ度疼痛达到61.57%，Ⅱ度疼痛达到28.23%，Ⅲ度疼痛达到10.2%；排便不畅以混合痔偏多，达到39%。结论：亚甲蓝长效镇痛剂用于肛肠病术后疼痛效果满意，但浓度不超过33%，一次用量不超过1 ml。实施镇痛时注意加强监测预防和及时处理不良反应和并发症。 　　[关键词] 亚甲蓝；肛肠病；镇痛 　　[中图分类号]R656[文献标识码]A [文章编号]1673-7210（2007）11（c）-010-02 　　 　　Clinical study of methylthioninium chloride on analgesia after anorectal diseases operation 　　WAN Kai-cheng 　　(The General Hospital Affiliated to Panzhihua Iron Steel Company, Panzhihua617023，China) 　　[Abstract] Objective:Post-operative analgesia of anorectal diseases was investigated in the study．Methods:The patients who had undergone anorectal operations received long-acting methylthioninium chloride compound．The indexes for evaluation included pain extents，physical aspects，postoperative adverse reactions and complications．Results:The analgesic efficacywas adopted.There was 61.57% whose pain reached Ⅰgrade after anorectal operation, 28.23% whose reaching Ⅱgrade,10.2% whose reaching Ⅲ grade.But the hard defecation was more than other groups on the mixed hemorrhoids which was 39%.Conclusion: It is concluded that the long-acting cethylthioninium chloride compound is better in terms of efficacy．It is suggested that the concentration of cethylthioninium chloride should not be more than 33%，and that the dosage of local injection should not be more than 1 ml．The attention should be taken in the aspects of nursing，prevention of adverse reaction and complications． 　　[Key words] Methylthioninium chloride； Anorectal disease； Analgesia 　　 　　疼痛是肛肠病术后的常见并发症，其疼痛程度是患者较难忍受的，我们以亚甲蓝为主组成长效镇痛剂进行临床应用，取得满意效果，报道如下： 　　 　　1 资料与方法 　　 　　1.1 临床资料 　　根据《中医病症诊断疗效标准》[1]收治混合痔患者82例，其中，男45例，女37例；年龄31～72岁，平均41岁；病程2～30年，平均8年。低位肛周脓肿58例，其中，男35例，女23例；年龄25～56岁，平均31岁；病程3～8 d，平均3.5 d。肛裂50例，其中，男20例，女30例；年龄19～58岁，平均28岁；病程6个月～5年，平均2.5年。低位肛瘘65例，其中，男42例，女23例；年龄27～60岁，平均37岁；病程2～30年，平均7年。 　　1.2 亚甲蓝长效止痛剂配制 　　1%亚甲蓝（江苏济川制药有限公司生产）1 ml，2%利多卡因5～10 ml，0.75%布比卡因5 ml，注射用水20～30 ml。 　　1.3 方法 　　手术结束时，以20 ml注射器