丁卡因凝胶肛内表麻联合在PPH术后镇痛中应用.docVIP

丁卡因凝胶肛内表麻联合在PPH术后镇痛中的应用 　　【摘要】 目的：探?本院自制丁卡因凝胶肛内表麻在PPH术后镇痛及并发症控制的可行性及有效性。方法：选择2016年8月-2017年7月在本院进行PPH手术的患者共100例，患者均在低浓度布比卡因腰麻下完成手术，其中50例术后留置硬膜外导管，接镇痛泵行硬膜外镇痛作为对照组。另外50例术后以涂有丁卡因凝胶的纱块填塞肛内压迫止血作为试验组。比较两组术后4、8、12、24、36 h的视觉模拟评分（VAS），术后排尿情况和术后并发症情况。结果：两组术后4、8、12、24、36 h的VAS评分均逐步降低，两组术后VAS评分比较，差异均无统计学意义（P0.05）。试验组术后仅发生尿潴留5例，心悸2例，恶心1例，术后并发症发生率12%，对照组术后发生尿潴留44例，其他并发症16例，术后并发症发生率92%，两组术后并发症发生率比较，差异有统计学意义（P0.05）。术后两组镇痛效果满意度分别为试验组98%，对照组96%，两组比较差异有统计学意义（P0.05）。试验组术后镇痛便捷度及镇痛费用满意度均为100%，均显著高于对照组的86%、76%，两组比较差异均有统计学意义（P0.05）。结论：丁卡因凝胶肛内表麻镇痛是一种简单、有效、经济的PPH术后镇痛方法，能够明显减轻术后患者的痛苦，大大降低并发症的发生，减轻患者负担，提高医疗满意度。 　　【关键词】 丁卡因凝胶； 吻合器痔上黏膜环切术； 镇痛； 并发症 　　【Abstract】 Objective：To investigate the effect of tetracaine gel on postoperative analgesia and complications in PPH patients.Method：100 patients with PPH surgery in our hospital from August 2016 to July 2017 were selected.They were operated under low concentrations of bupivacaine and spinal anesthesia，50 cases of epidural catheter was placed postoperatively and analgesic pump was used to relieve epidural analgesia as control group，and 50 patients were treated with gauze filled with tetracaine gel to inner anus compression hemostasis as experimental group.4，8，12，24 and 36 h of postoperative visual analogue score（VAS），postoperative complications and postoperative urination were compared between two groups.Result：The postoperative VAS scores of 4，8，12，24 and 36 h in two groups were decreased gradually，the postoperative VAS scores of two groups were compared，the differences were not statistically significant（P0.05）.The postoperative complication rate of the experimental group was 12%，included 5 cases of urinary retention，2 cases of palpitation，1 case of nausea，the postoperative complication rate of the control group was 92%，included 44 cases of urinary retention occurred and 16 cases of others，the postoperative complication rate of two groups were compared，the difference was statistically significant（P 　　【Key words】 Tetracaine gel； PPH； Analgesia；