摘要
目的探究亚甲蓝、罗哌卡因混合液联合奥布卡因凝胶对混合痔外剥内扎术后的镇痛效果。方法根据纳入与排除标准,选取广东医科大学附属第三医院(佛山市顺德区龙江医院)普外科2021年1—10月收治的椎管内麻醉下行外剥内扎术混合痔患者90例为研究对象,按照随机数字表法将其分为观察组、对照A组、对照B组,每组各30例。对照A组予以1%亚甲蓝2 ml、生理盐水8 ml,制成0.2%亚甲蓝液10 ml进行伤口皮下注射;对照B组予以1%亚甲蓝2 ml、5%罗哌卡因5 ml、生理盐水3 ml配制成0.2%亚甲蓝混合液10 ml进行伤口皮下注射;观察组予以亚甲蓝、罗哌卡因混合液联合奥布卡因凝胶进行伤口皮下注射。观察三组疗效指标[各时间节点视觉模拟量表(VAS)评分、不良反应发生率及生活质量]。结果观察组术后2 h、首次大便前、首次换药前、换药中以及换药后30 min的VAS评分均低于对照A组、对照B组(P<0.05);观察组伤口灼烧感、尿潴留、创缘水肿及术后排便困难不良反应发生率均低于对照A组、对照B组(P<0.05);观察组生活质量量表各评分均高于对照A组、对照B组(P<0.05)。结论针对混合痔外剥内扎术后患者的镇痛治疗,为患者联合应用亚甲蓝、罗哌卡因及奥布卡因凝胶更能有效改善患者术后各项指标,可促进患者术后的康复,更具临床实用性及安全性。
Objective To investigate the analgesic effect of methylene blue and ropivacaine mixture combined with oxybuprocaine gel on patients undergoing external dissection and internal ligation for mixed hemorrhoids.Methods A total of 90 patients with mixed hemorrhoids who underwent external dissection and internal ligation under intraspinal anesthesia in the Department of General Surgery of the Third Affiliated Hospital of Guangdong Medical University(Longjiang Hospital of Shunde District in Foshan City)from January to October 2021 were selected as study subjects according to the inclusion and exclusion criteria.They were divided into 30 cases each in the observation group,control group A and control group B according to the random number table method.The control group A was injected subcutaneously into the wound with 10 ml of 0.2%methylene blue solution prepared with 1%methylene blue 2 ml and normal saline 8 ml,the control group B was injected subcutaneously into the wound with 10 ml of 0.2%methylene blue mixture prepared with 1%methylene blue 2 ml,5%ropivacaine 5 ml and normal saline 3 ml,and the observation group was injected subcutaneously into the wound with methylene blue and ropivacaine mixture combined with oxybuprocaine gel.The efficacy indexes(Visual Analogue Scale[VAS]score,incidence of adverse reactions and quality of life at each time point)in the three groups were observed.Results The VAS scores of the observation group were lower than those of control group A and control group B at 2 h after surgery,before the first stool defecation,before the first drug change,during the drug change and 30 min after the drug change(P<0.05).The incidences of adverse reactions such as wound burning sensation,urinary retention,edema at the wound edge and difficulty in defecation after surgery were lower than those of control group A and control group B(P<0.05).The scores of quality of life in observation group were higher than that in control group A and control group B(P<0.05).Conclusion During the analgesic treatment of patients undergoing external dissection and internal ligation for mixed hemorrhoids,the combined application of methylene blue,ropivacaine and oxybuprocaine gel is more effective in improving the postoperative indexes and can promote postoperative recovery of patients,which is of hig her clinical practicability and safety.
作者
张周文
李文霞
夏联山
邓静
刘明焱
ZHANG Zhouwen;LI Wenxia;XIA Lianshan;DENG Jing;LIU Mingyan(Department of General Surgery,the Third Affiliated Hospital of Guangdong Medical University(Longjiang Hospital of Shunde District in Foshan City),Guangdong,Foshan 528300,China)
出处
《中国医药科学》
2022年第12期70-73,共4页
China Medicine And Pharmacy
基金
广东省佛山市卫生健康局医学科研课题(20210296)。
关键词
亚甲蓝
罗哌卡因
奥布卡因凝胶
混合痔
镇痛治疗
Methylene blue
Ropivacaine
Oxybuprocaine gel
Mixed hemorrho ids
Analgesic treatment
