摘要
目的 比较纳布啡与羟考酮在胆囊术后患者中的镇痛效果。方法 纳入2021年8月至2023年8月行腹腔镜胆囊切除术的80例患者进行随机对照研究,依据入院先后顺序将其分为对照组与治疗组,每组40例。对照组术后应用羟考酮进行静脉自控镇痛,治疗组术后应用纳布啡进行静脉自控镇痛。比较两组的切口痛、内脏痛评分、自控镇痛按压次数、肠鸣音恢复时间、通气时间、下床活动时间、住院时间、应激反应指标及不良反应发生情况。结果 术后1、4、12 h,两组的切口痛、内脏痛评分无显著差异(P>0.05)。两组的自控镇痛按压次数无显著差异(P>0.05);治疗组的肠鸣音恢复时间、通气时间、下床活动时间及住院时间均短于对照组(P<0.05)。术后,两组的内皮素(ET)、超氧化物歧化酶(SOD)及皮质醇(COR)水平高于术前,但治疗组低于对照组(P<0.05)。治疗组的不良反应总发生率明显低于对照组(P<0.05)。结论 纳布啡与羟考酮均能够降低胆囊术后患者的疼痛程度,且纳布啡可明显降低应激反应,缩短康复进程,安全性较高。
Objective To compare the analgesic effect of nalbuphine and oxycodone in patients after gallbladder surgery.Methods A total of 80 patients who underwent laparoscopic cholecystectomy from August 2021 to August 2023 were included for randomized controlled study.The patients were divided into control group and treatment group according to the order of admission,with 40 cases in each group.The control group was treated with oxycodone for intravenous controlled analgesia after operation,and the treatment group was treated with nalbuphine for intravenous controlled analgesia after operation.The incision pain,visceral pain scores,number of self-controlled analgesia presses,recovery time of bowel sounds,ventilation time,ambulation time,hospitalization time,stress response indicators and adverse reactions were compared between the two groups.Results At 1,4 and 12 h after operation,there were no significant differences in the scores of incision pain and visceral pain between the two groups(P>0.05).There was no significant difference in the number of self-controlled analgesia presses between the two groups(P>0.05);the recovery time of bowel sounds,ventilation time,ambulation time and hospitalization time in the treatment group were shorter than those in the control group(P<0.05).After operation,the levels of endothelin(ET),superoxide dismutase(SOD)and cortisol(COR)in the two groups were higher than those before operation,but those in the treatment group were lower than the control group(P<0.05).The total incidence of adverse reactions in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion Both nalbuphine and oxycodone can reduce the pain degree of patients after gallbladder surgery,and nalbuphine can significantly reduce the stress response and shorten the rehabilitation process,has higher safety.
作者
李晓报
刘昊
LI Xiaobao;LIU Hao(Zichang People's Hospital,Yan'an 717300;Yanchang County People's Hospital,Yan'an 717199,China)
出处
《临床医学研究与实践》
2025年第15期102-105,共4页
Clinical Research and Practice
关键词
纳布啡
羟考酮
胆囊手术
疼痛程度
应激反应
nalbuphine
oxycodone
gallbladder surgery
pain degree
stress response
作者简介
李晓报(1990-),男,主治医师,学士。研究方向:围术期超声与舒适化医疗;通讯作者:刘昊,E-mail:403278158@qq.com.
