羟考酮在腹腔镜胆囊切除术后镇痛中的应用及对凝血功能的影响

目的:分析羟考酮在腹腔镜胆囊切除术后镇痛中的应用及对凝血功能的影响。方法:选择2015年5月~2016年5月于我院行腹腔镜胆囊切除术患者106例,依据抽签法分成对照组与实验组,各有53例,对照组予以芬太尼镇痛,实验组予以羟考酮镇痛,比较两组痛觉指标5-羟色胺(5-HT)、P物质]、疼痛数字评分(NRS)、凝血功能凝血酶原时间(PT)、纤维蛋白原(Fg)、活化部分凝血酶原时间(APTT)、血小板计数(PLT)]、血流动力学、炎症因子、应激指标、麻醉效果和安全性。结果:干预后,实验组5-HT、P物质水平、NRS评分、PT、Fg、APTT、PLT以及血流动力学、炎症因子、应激指标均低于对照组,差异具有统计学意义(P0.05)。两组麻醉效果比较差异无统计学意义(P0.05)。实验组不良反应率显著低于对照组(P0.05)。结论:腹腔镜胆囊切除术应用羟考酮的镇痛作用与芬太尼相当,但能够更有效减轻术后血液的高凝状态。

Application of Oxycodone on the Analgesia and Its Influence on the Blood Coagulation Function after Laparoscopic Cholecystectomy

ABSTRACT Objective: To analyze the application of oxycodone on the analgesia after laparoscopic cholecystectomy and its influ- ence on the blood coagulation function. Methods: 106 cases of laparoscopic cholecystectomy patients from May 2015 to May 2016 in our hospital were selected and divided into the control group and experimental group according to the lottery method with 53 cases in each group, the control group was given fentanyl analgesia, the experimental group was given oxycodone analgesia, the pain index serotonin (5-HT) and substance P], numerical rating scale(NRS), blood coagulation function prothrombin time (PT), fibrinogen (Fg), activated par- tial prothrombin time (APTT), platelet count (PLT)], hemodynamic, inflammatory factor, stress index, anesthetic effect and safety were compared between the two groups before and after intervention. Results: After the operation, the 5-HT, substance P levels, NRS score, Fg, APTT, PT, PLT, hemodynamic, inflammation factors, stress index in the experimental group were significantly lower than those of the control group(P<0.05). No statistical significance was found in the anesthesia effect between two groups(P>0.05). The adverse reac- tion rate in experimental group was obviously lower than that of the control group (P<0.05). Conclusion: The analgesic action was equal of oxycodone in laparoscopic cholecystectomy to Fentanyl, which could reduce the blood high condensation state.