不同方式镇痛方法对于老年髋部手术术后镇痛临床观察.doc

不同方式的镇痛方法对于老年髋部手术术后镇痛的临床观察 　　摘要：目的 探讨用不同的镇痛治疗应用于老年髋部骨折患者的临床效果和不良反应，研究理想的镇痛药物对于老年人术后的并发症的预防很有必要。方法 老年髋部骨折患者60例，随机分为（实验组）帕瑞昔布组30例，（对照组）芬太尼组30例，对照两组不同药物的镇痛方法，观察术后镇痛效果、阿片类药物的用量，不良反应发生等指标。结果 表明实验组在术后6、8、12 h VAS值明显小于对照组（P0.05），但实验组阿片类药物明显少于对照组，而不良反应发生机率（即恶心、呕吐、尿储留、皮肤瘙痒），明显实验组要少于对照组。结论 本研究表明老年髋部手术，术前术后镇痛应用帕瑞昔布进行治疗更加有效，更加安全、不良反应也是大大减少 关键词：帕瑞昔布；髋部骨折；术后镇痛 Clinical Observation of Different Methods of Analgesia for Postoperative Analgesia in Elderly Patients Undergoing Hip Surgery CHEN Xiao-ming，ZHU Jian-wei，WANG Chang-fu （Dachang Hui Autonomous County People’s Hospital，Dachang 065300，Hebei，China） Abstract：Objective To explore the clinical effects and adverse reactions of different analgesic treatments for elderly patients with hip fracture， and the study of the ideal analgesic drugs for the prevention of postoperative complications of the elderly is necessary. Methods In 60 cases of elderly patients with hip fracture， 30 cases were randomly divided into Parecoxib group （experimental group）， and the other cases were divided into Fentanyl group （control group）， and the analgesic methods with different drugs in the two groups were compared， and the postoperative analgesic effects， the dosage of opioids， the adverse reactions and other indexes were observed.Results The VAS value of the experimental group was significantly less than that of the control group （P0.05）， however， the dosage of opioids of the experimental group was significantly less than that of the control group， and the incidence of adverse reactions （nausea， vomiting， urinary retention， pruritus） in the experimental group was significant less than the control group. Conclusion It shows in the study that， in the elderly patients received hip surgeries， the application of Parecoxib for the treatment of preoperative and postoperative analgesia is more effective and safer， and the incidence of adverse reactions was also greatly reduced. Key words：Parecoxib；Hip fracture；Postoperative analgesic 老年人髋部骨