摘要
目的观察超前镇痛对股前外侧穿支皮瓣术患者镇痛的效果以及比较患者血管危象情况。方法将120例择期行股前外侧穿支皮瓣移植术患者按随机数字表法分为A组(60例)和B组(60例),其中男性85例,女性35例;年龄35-55岁,平均44.05岁。重物砸伤38例,道路交通伤47例,机器绞伤24例,刀砍伤5例,电击伤4例,锅炉烫伤1例,蛇咬伤致皮肤坏死1例。A组在术前30min使用帕瑞昔布钠40mg静脉注射进行超前镇痛,B组不注射帕瑞昔布钠。比较两组术后镇痛药物使用情况、术后数字量表评分(NRS)及血管危象情况。结果本组患者均获1个月随访,皮瓣均成活。两组患者术后24h使用镇痛药(双氯芬酸钠)例数A组低于B组(P〈0.05),术后6、12、24 h A组NRS评分低于B组(P〈0.05),术后48h两组比较差异无统计学意义(P〉0.05)。血管危象发生例数A组低于B组(P〈0.05)。结论股前外侧穿支皮瓣移植术患者应用超前镇痛明显减轻术后疼痛,降低术后血管危象发生率,提高术后镇痛满意度。
Objective To observe the effect of preemptive analgesia on the anterolateral thigh flap in patients undergoing analgesia.Methods Totally 120 patients[85 males and 35 females ranged from 35-55(average,44.05)years]undergoing femoral anterolateral thigh perforator flap transplantation were divided into group A(60cases)and group B(60 cases).Among them 38 were injured from heavy objects,47 from traffic accidents,24 from machines,5 from knives,4 from electrical injury,1 from scald and 1 from snake bites.Patients in group A were managed with 40 mg intramuscular injection of parecoxib sodium for preemptive analgesia at 30 min before operations,and patients in group B were not injected parecoxib sodium.Results All patients received 1 months of follow-up,and all the flaps survived.After 24 h of operation,the number of cases in group A in use of analgesic drugs(diclofenac sodium)was smaller than that of group B(P〈0.05).After 6h,12 h,24h,the NRS score of group A was lower than that of group B(P〈0.05),while there was no significant difference at 48 h after operations between the two groups(P〈0.05).The number of cases of vascular crisis occurred in group A was smaller than that of group B(P〈0.05).Conclusion The application of preemptive analgesia in patients with anterolateral thigh flap transplantation significantly reduced postoperative pain and the incidence of postoperative vascular crisis,increasing patients'postoperative satisfaction.
作者
白艳
李霞
杜棣
徐晓燕
吴一芃
凌云霞
BAI Yan;LI Xia;DU Di;XU Xiao-yan;WU Yi-peng(Research Institute of Orthopaedic Trauma of PLA,Deparment of Orthopaedics,Kunming General Hospital of Chengdu MilitaryCommand,Kunming650032,China)
出处
《创伤外科杂志》
2016年第8期469-471,共3页
Journal of Traumatic Surgery
关键词
超前镇痛
皮瓣
股前外侧
preemptive analgesia
flap
anterolateral thigh
