| 侯宇姝,王 跃,程丽敏.不同镇痛方式在混合痔术后镇痛中的应用效果分析[J].中国烧伤创疡杂志,2021,(4):299~302. |
| DOI： |
| 中文关键词: 亚甲蓝 罗哌卡因 高乌甲素 术后镇痛 混合痔 |
| 英文关键词:Methylene blue Ropivacaine Lappaconitine Postoperative analgesia Mixed hemorrhoids |
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| 中文摘要: |
| 【摘要】 目的 对比分析不同镇痛方式在混合痔术后镇痛中的应用效果。方法 选取 2019 年 4 月至 2019 年 12 月黑龙江中医药大学附属第一医院收治的90例拟行手术治疗的混合痔患者作为研究对象, 并按照随机数表法将其随机分为甲组、乙组和丙组, 每组 30 例。混合痔术后，甲组患者采用高乌甲素+罗哌卡因+亚甲蓝+肾上腺素+生理盐水混合液进行镇痛，乙组患者采用罗哌卡因+亚甲蓝+肾上腺素+生理盐水混合液进行镇痛，丙组患者采用利多卡因+亚甲蓝+肾上腺素+生理盐水混合液进行镇痛。对比3 组患者术后1? 2、 3、7 d 的视觉模拟评分法 (VAS) 评分变化情况及术后 7 d 创面水肿情况? 结果 术后 1、2、3、7 d，甲组患者 VAS 评分均明显低于乙组和丙组 (术后 1 d: q = 17. 420、45. 380，P 均 < 0. 001；术后 2 d: q = 16. 270、39. 050，P 均 < 0. 001；术后 3 d: q = 19. 880、36. 730，P 均 < 0. 001；术后 7 d: q = 17. 280、35. 870，P均 < 0. 001)，乙组患者 VAS 评分又明显低于丙组 (q = 27. 950、22. 780、16. 850、18. 580，P 均 < 0. 001); 术后 7 d，甲组患者创面水肿程度评分明显低于乙组和丙组 (q = 8. 061、7. 658，P 均 < 0. 001)，而乙组和丙组间无明显差异 ( q = 0. 403，P = 0. 956)? 结论 高乌甲素与亚甲蓝、罗哌卡因、肾上腺素联合应用于混合痔术后，能够有效降低患者的疼痛程度及创面水肿程度, 效果明显优于亚甲蓝、罗哌卡因、肾上腺素联合镇痛以及亚甲蓝、利多卡因、肾上腺素联合镇痛。 |
| 英文摘要: |
| 【Abstract】 Objective To compare and analyze the analgesic effect of different analgesic methods applied in mixed hemorrhoid surgery. Methods Ninety patients with mixed hemorrhoids, admitted to the Proctology Department of The First Affiliated Hospital of Heilongjiang University of Chinese Medicine from April 2019 to December 2019, were selected as research subjects. They were divided, according to the random number table, into group A, group B and group C, with 30 cases in each group. After mixed hemorrhoid operation, patients in group A were given the mixture of Lappaconitine + Ropivacaine + Methylene blue + Epinephrine + normal saline for analgesia, patients in group B were given the mixture of Ropivacaine + Methylene blue + Epinephrine + normal saline, and patients in group C were given the mixture of Lidocaine + Methylene blue + Epinephrine + normal saline. Change of visual analogue scale (VAS) scores respectively onday 1, 2, 3, and 7 after the operation, and the wound edema on day 7 after the operation were compared between the three groups. Results Respectively on day 1, 2, 3, and 7 after the operation, the VAS scores of patients in the group A were all significantly lower than that in the group B and group C ( day 1 after the operation: q = 17. 420 and 45. 380, both P < 0. 001; on day 2 after the operation: q = 16. 270 and 39. 050, both P < 0. 001; day 3 after the operation: q = 19. 880 and 36. 730, both P < 0. 001; day 7 after the operation: q = 17. 280 and 35. 870, both P < 0. 001), at the same time the VAS scores of patients in the group B were all significantly lower than that in the group C ( q = 27. 950, 22. 780, 16. 850 and 18. 580, all P < 0. 001). On day 7 after the operation, the score of wound edema in the group A was significantly lower than that in the group B and group C ( q = 8. 061 and 7. 658, both P < 0. 001), while no significant difference was observed between the group B and group C ( q = 0. 403, P = 0. 956). Conclusion The combined application of Lappaconitine, Methylene blue, Ropivacaine, and Epinephrine after the operation of mixed hemorrhoid can significantly reduce patients’ pain and alleviate their wound edema, and the analgesic effect is much better than that of the combined application of Meth? ylene blue, Ropivacaine, and Epinephrine, or the combined application of Methylene blue, Lidocaine and Epinephrine. |
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