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1、美蓝注射联合PCIA用于肛肠病患者术后镇痛效果观察研宄马月丽郭文义2(山西职工医学院附属医院手术麻醉科太原030012)【摘要]0的:研宄肛肠疾病患者术后美蓝注射联合静脉自控镇痛(PCIA)的效果和不良反应。方法:选择肛肠病患者手术90例(ASAI〜II)，随机分为2组(A组、B组>，每组30例。其中，A组为联合镇痛组，手术结束时局部美蓝注射+PCIA;B为单纯PCIA组。采用视觉模拟评分(VAS)和患者舒适状态评分(BCS)观察记录两组术后4h、8h、24h、48h、60h疼痛强度和舒适状态，观察60h内不良反应的发生率。结果：术后4
2、h、8h、24h、48h两组患者VAS评分比较无显著性统计学意义(P〉0.05),但是术后60h镇痛泵撤除后两组患者VAS评分A组低于B组(P<0.05)；术后4h、8h、24h、48h两组患者BCS评分比较无S著性统计学意义(P〉0.05),但是术后60h两组患者BCS评分A组高于B组(P<0.05)；两组患者术后恶心呕吐、尿潴留、上消化道出血发生率比较无显著性统计学意义(P〉0.05),但B组头晕发生率较A组高(P<0.05)o结论:美兰注射联合PCIA的镇痛模式用于肛肠手术患者在保证镇痛效果的同时，降低了不良反应发生率，延长了镇痛时
3、间，更为有效的减轻患者的痛苦，患者更为舒适。【关键词】美蓝；舒芬太尼；酮咯酸氨丁三醇；静脉自控镇痛(PCIA)【中图分类号】R614【文献标识码】【文章编号】ObservationandResearchonpostoperativeanalgesiceffectofcombinedinjectionofMethyleneblueandPCIAforanorectalpatients.MAyue-li,GUOwen-yi.DepartmentAnesthesiology,TheShanXiMedicalUniversity.The•Taiy
4、uan030012,ChinaIAbstract]ObjectiveTostudytheanalgesiceffectandadversereactionofcombinedadministrationofMethylthioniniumChlorideandPCIAforpostoperativeanorectalpatients.Methods90postoperativeanorectalpatients(ASAI~II)wererandomlydividedinto2groups(groupA,B),30casesineachgr
5、oup.PatientsingroupAweregivencombinedinjectionofMethylthioniniumChlorideandPCIAafteroperation.GroupBweresimplytreatedwithPCIA.Usingthevisualanaloguescale(VAS)toobservethepainintensityandincidenceofadversereactionsinthetwogroupsrespectively4h,8h,24h,48h,60hafteroperation.R
6、esultResultsassessedbyVASinbothgroups4h,8h,24h,48hafteroperationshowednosignificantstatisticaldifference(P>0.05),however,groupAwerelowerthangroupB(P<0.05)60hafteroperationwhentheanalgesicpumpswereremoved.ResultsevaluatedbyBCSinbothgroups4h,8h,24h,48hafteroperationshowedno
7、significantstatisticaldifference,butgroupAwerehigherthangroupB(P<0.05)60hafteroperation.HigherincidenceofdizzinessingroupBcomparedwithgroupA(P<0.05)wasobserved.Otherincidenceofadversereactionsshowednosignificantstatisticaldifference.ConclusionsCombinedadministrationofMeth
8、ylthioniniumChlorideandPCIAisbetterthansimpletreatmentwithPCIAforpostoperativeanorectalpatients.
