不同方式的镇痛方法对于老年髋部手术术后镇痛的临床观察(1)
摘要：目的 探讨用不同的镇痛治疗应用于老年髋部骨折患者的临床效果和不良反应，研究理想的镇痛药物对于老年人术后的并发症的预防很有必要。方法 老年髋部骨折患者60例，随机分为(实验组)帕瑞昔布组30例，(对照组)芬太尼组30例，对照两组不同药物的镇痛方法，观察术后镇痛效果、阿片类药物的用量，不良反应发生等指标。结果 表明实验组在术后6、8、12 h VAS值明显小于对照组(P<0.05)；24 h VAS值基本接近(P>0.05)，但实验组阿片类药物明显少于对照组，而不良反应发生机率(即恶心、呕吐、尿储留、皮肤瘙痒)，明显实验组要少于对照组。结论 本研究表明老年髋部手术，术前术后镇痛应用帕瑞昔布进行治疗更加有效，更加安全、不良反应也是大大减少。
关键词：帕瑞昔布；髋部骨折；术后镇痛
Clinical Observation of Different Methods of Analgesia for Postoperative Analgesia in Elderly Patients Undergoing Hip Surgery
, 百拇医药
CHEN Xiao-ming，ZHU Jian-wei，WANG Chang-fu
(Dachang Hui Autonomous County People's Hospital，Dachang 065300，Hebei，China)
Abstract：Objective To explore the clinical effects and adverse reactions of different analgesic treatments for elderly patients with hip fracture， and the study of the ideal analgesic drugs for the prevention of postoperative complications of the elderly is necessary. Methods In 60 cases of elderly patients with hip fracture， 30 cases were randomly divided into Parecoxib group (experimental group)， and the other cases were divided into Fentanyl group (control group)， and the analgesic methods with different drugs in the two groups were compared， and the postoperative analgesic effects， the dosage of opioids， the adverse reactions and other indexes were observed.Results The VAS value of the experimental group was significantly less than that of the control group (P<0.05) at 6， 8 and 12 hours after operation； and the VAS values at 24 hours were similar (P>0.05)， however， the dosage of opioids of the experimental group was significantly less than that of the control group， and the incidence of adverse reactions (nausea， vomiting， urinary retention， pruritus) in the experimental group was significant less than the control group. Conclusion It shows in the study that， in the elderly patients received hip surgeries， the application of Parecoxib for the treatment of preoperative and postoperative analgesia is more effective and safer， and the incidence of adverse reactions was also greatly reduced.
, 百拇医药
Key words：Parecoxib；Hip fracture；Postoperative analgesic
老年人髋部骨折术后疼痛，直接影响患者的睡眠、饮食、情绪，增加重要器官并发症的发生率，手术时合理的麻醉方法非常重要，但术前、术后良好的镇痛方法对于减少术后老年患者的应激反应尤为重要。疼痛主要是由于骨骼、肌肉、软组织等损伤引起，如果处理不当，轻则导致术后高致残率，延长住院时间，增加医疗费用，重则可危及生命。目前手术治疗还是老年髋部骨折患者最好的治疗方法，但手术治疗对于骨折患者来说，属于伤后的二次打击，在此过程中机体会产生不同程度的各种应激反应及疼痛，会持续几天，造成机体内环境功能紊乱和失调，直接影响手术效果和术后康复，而效果确切，不良反应少的镇痛方法，为手术治疗，起到了很强有力的保障效果。2014年10月～2015年10月在我们医院采用帕瑞昔布钠对30例老年髋部骨折患者进行术后镇痛，并与同期进行的舒芬太尼组30例老年髋部骨折患者术后镇痛进行对比，报道如下。, http://www.100md.com(陈晓明 朱见伟 王长富)
关键词：帕瑞昔布；髋部骨折；术后镇痛
Clinical Observation of Different Methods of Analgesia for Postoperative Analgesia in Elderly Patients Undergoing Hip Surgery
, 百拇医药
CHEN Xiao-ming，ZHU Jian-wei，WANG Chang-fu
(Dachang Hui Autonomous County People's Hospital，Dachang 065300，Hebei，China)
Abstract：Objective To explore the clinical effects and adverse reactions of different analgesic treatments for elderly patients with hip fracture， and the study of the ideal analgesic drugs for the prevention of postoperative complications of the elderly is necessary. Methods In 60 cases of elderly patients with hip fracture， 30 cases were randomly divided into Parecoxib group (experimental group)， and the other cases were divided into Fentanyl group (control group)， and the analgesic methods with different drugs in the two groups were compared， and the postoperative analgesic effects， the dosage of opioids， the adverse reactions and other indexes were observed.Results The VAS value of the experimental group was significantly less than that of the control group (P<0.05) at 6， 8 and 12 hours after operation； and the VAS values at 24 hours were similar (P>0.05)， however， the dosage of opioids of the experimental group was significantly less than that of the control group， and the incidence of adverse reactions (nausea， vomiting， urinary retention， pruritus) in the experimental group was significant less than the control group. Conclusion It shows in the study that， in the elderly patients received hip surgeries， the application of Parecoxib for the treatment of preoperative and postoperative analgesia is more effective and safer， and the incidence of adverse reactions was also greatly reduced.
, 百拇医药
Key words：Parecoxib；Hip fracture；Postoperative analgesic
老年人髋部骨折术后疼痛，直接影响患者的睡眠、饮食、情绪，增加重要器官并发症的发生率，手术时合理的麻醉方法非常重要，但术前、术后良好的镇痛方法对于减少术后老年患者的应激反应尤为重要。疼痛主要是由于骨骼、肌肉、软组织等损伤引起，如果处理不当，轻则导致术后高致残率，延长住院时间，增加医疗费用，重则可危及生命。目前手术治疗还是老年髋部骨折患者最好的治疗方法，但手术治疗对于骨折患者来说，属于伤后的二次打击，在此过程中机体会产生不同程度的各种应激反应及疼痛，会持续几天，造成机体内环境功能紊乱和失调，直接影响手术效果和术后康复，而效果确切，不良反应少的镇痛方法，为手术治疗，起到了很强有力的保障效果。2014年10月～2015年10月在我们医院采用帕瑞昔布钠对30例老年髋部骨折患者进行术后镇痛，并与同期进行的舒芬太尼组30例老年髋部骨折患者术后镇痛进行对比，报道如下。, http://www.100md.com(陈晓明 朱见伟 王长富)