發(fā)布時間：2019-07-05 09:28

【摘要】：[目的]對比納布啡與舒芬太尼應用于小兒術后鎮(zhèn)痛的臨床效果,并設置兩組不同劑量納布啡進行臨床效果比較,觀察納布啡用于小兒術后鎮(zhèn)痛的安全性及有效性,為臨床兒科使用納布啡提供一個劑量參考。[方法]選擇擇期行扁桃體切除(低溫等離子射頻消融術)的手術患者120例隨機分為4組,每組30例。均于手術結束前10分鐘給予PCA,A組:納布啡1.0 mg/kg+尼松 0.5mg/kg+地塞米松 0.15mg/kg; B 組:納布啡 1.5mg/kg+尼松 0.5mg/kg+地塞米0.15 mg/kg; C組:舒芬太尼1 μg/kg+尼松0.5 mg/kg+地塞米松0.15 mg/kg;D組:空白組(術后未使用鎮(zhèn)痛泵)。[結果]A、B、C三組兩兩間比較術后FLACC疼痛評分在術后2 h、12 h、24 h、48 h比較差異無統(tǒng)計學意義(P值0.05),在術后4h疼痛評分A組與B、C組比較差異有統(tǒng)計學意義(P值0.05);在術后8h,A、C組與B組比較有統(tǒng)計學意義(P值0.05),A組與C組比較差異無統(tǒng)計學意義(P值0.05),A、B、C三組患兒術后鎮(zhèn)靜評分比較在術后2 h比較差異無統(tǒng)計學意義(P0.05),在術后4h、8h, A、C組與B組比較差異有統(tǒng)計學意義(P值0.05),A、C兩組比較差異無統(tǒng)計學意義(P值0.05) , A、B、C三組與D組比較住院時間、術后FLACC疼痛評分、術后鎮(zhèn)靜評分差異均有統(tǒng)計學意義(P值0.05)。[結論]1 mg/kg納布啡復合尼松及地塞米松用于小兒輕、中度術后靜脈鎮(zhèn)痛效果好,鎮(zhèn)靜效果滿意,能有效減少術后煩躁,不良反應少,可安全用于小兒術后鎮(zhèn)痛。
[Abstract]:[objective] to compare the clinical effects of naborphine and sufentanil in postoperative analgesia in children, and to compare the clinical effects of naborphine with sufentanil in different doses, so as to observe the safety and effectiveness of naborphine in postoperative analgesia in children, and to provide a dose reference for clinical use of naborphine in pediatrics. [methods] 120 patients undergoing elective tonsillectomy (hypothermic plasma radiofrequency ablation) were randomly divided into 4 groups with 30 patients in each group. All patients were given PCA,A 10 minutes before the end of operation: naborphine 1.0 mg/kg nisone 0.5mg/kg dexamethasone 0.15 mg 路kg, group B: naborphine 1.5mg/kg 0.5mg/kg desemide 0.15 mg / kg, group C: sufentanil 1 渭 g/kg nison 0.5mg/kg dexamethasone 0.15 mg 路kg ~ (- 1), group D: control group (no analgesic pump after operation), group C: sufentanil 1 渭 g/kg nison dexamethasone 0.15 mg 路kg ~ (- 1), group D (no analgesic pump after operation), group B (naborphine 1.0 mg 路kg ~ (- 1). [results] there was no significant difference in FLACC pain score between group A and group B at 2 h, 12 h, 24 h and 48 h after operation, but there was significant difference between group A and group B at 4 h after operation (P < 0.05). At 8 hours after operation, there was significant difference between group C and group B (P < 0.05). There was no significant difference in postoperative sedation score between group C and group B (P < 0.05). There was no significant difference in sedation score between group C and group B at 2 h after operation (P < 0.05). At 4 h, 8 h after operation, there was significant difference between group C and group B (P < 0.05), A,). There was no significant difference between group C and group D (P < 0.05). There was no significant difference in hospitalization time, postoperative FLACC pain score and sedation score between group A, group B and group D. [conclusion] 1 mg/kg naborphine combined with nisolone and dexamethasone has good intravenous analgesia effect and satisfactory sedation effect in children with mild and moderate postoperative analgesia. It can effectively reduce postoperative irritability and less adverse reactions, so it can be safely used in postoperative analgesia in children.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R726.1

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