双氯芬酸钠利多卡因在心脏外科术后的镇痛观察(1)
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[摘要] 目的：探讨双氯芬酸钠利多卡因在心脏外科手术后镇痛的临床疗效及安全性。方法：将89例成人风湿性心脏病患者分为两组。1组50例患者肌内注射双氯芬酸钠利多卡因75 mg，每天1次，2组39例患者使用氨酚双氢可待因(对乙酰氨基酚500 mg+酒石酸双氢可待因10 mg)，8 h/次，必要时加用盐酸哌替啶等阿片类止痛药物。比较两组药物的镇痛效果及副作用。结果：治疗前两组疼痛评分差异无统计学意义(P>0.05)，用药后1、6、12、24 h两组治疗效果比较，差异具有统计学意义(P<0.05)，1组镇痛效果较优且无药物不良反应。结论：双氯芬酸钠利多卡因在心脏外科术后有较好的镇痛效果，不良反应少，应用方便，能减少阿片类药物的使用，值得临床推广。
[关键词] 双氯芬酸钠；利多卡因；镇痛
[中图分类号] R614 [文献标识码]A[文章编号]1673-7210(2011)07(c)-093-02
The analgesic efficacy of Diclofenac Sodium Lidocaine Hydrochloride Injection in patients after cardiac surgery
CHEN Qiansu, HU Xuanyi*, WU Guansheng, LI Xuejun, YANG Siyuan, PENG Wanfu
Department of Cardiac Surgery, the Affiliated Hospital of Guiyang Medical College, Guizhou Province, Guiyang 550004, China
[Abstract] Objective: To evaluate the efficacy and safety of Diclofenac Sodium Lidocaine Hydrochloride Injection in treatment of analgesia after cardiac surgery. Methods: 89 cases of adult rheumatic heart disease patients were divided into two groups. 50 cases of patients in group 1 were given intermuscular injection of Diclofenac Sodium Lidocaine Hydrochloride once a day. 39 cases of patients in group 2 were given Paracetamol and Dihydrocodeine Tartrate Tablets every 8 h and intermuscular injection of Pethidine in necessity. The analgesic efficacy and side effects were compared between the two groups. Results: There were no statisticant difference between two groups before treatment (P>0.05), while differences between the two groups after 1, 6, 12, 24 h treatment were significant (P<0.05). The analgesic efficacy of group 1 was better and the side effect was lower than group 2. Conclusion: Because of satisfying effect, low side effect, convenience and reducing opioids usage, Diclofenac Sodium Lidocaine Hydrochloride Injection is worth to apply in patients after cardiac surgery.
[Key words] Diclofenac Sodium; Lidocaine Hydrochloride; Analgesia
术后疼痛可致患者烦躁、咳嗽及呼吸困难，痰液不易排出，容易导致和加重肺部感染。同时疼痛还引起机体释放儿茶酚胺、醛固酮、皮质醇及肾素血管紧张素等内源性物质，这些激素促进水钠潴留，使患者心率增快，全身血管阻力增加，心脏负荷增加，导致高血压、心动过速、心律失常及心肌缺血等并发症。因此对心脏手术患者进行术后镇痛有重要的临床意义。双氯芬酸钠利多卡因是一种新型的非甾体类的强有力镇痛剂。目前有关该药在心脏外科术后镇痛的文献报道不多，因此，笔者进行了相关对照研究，现报道如下：
1 资料与方法
1.1 一般资料
随机选取89例患者，男38例，女51例；平均年龄(43.57±13.05)岁。全部患者均在术前行超声心动图、冠状动脉CT检查 ......
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