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find Author "刘文良" 2 results
  • Efficiency and Gastrointestinal Reaction of Subcutaneous Fentanyl Analgesic in Postoperative Patients

    【摘要】 目的 比较术后芬太尼皮下镇痛(PCSA)与硬膜外镇痛(PCEA)的临床效果,以及对胃肠功能的影响。 方法 2009年1-6月间观察择期硬膜外麻醉下经腹子宫切除术患者120例,术后分别实施PCSA与PCEA,观察术后第4、8、12、24、48 h的镇痛、镇静情况,呼吸循环、恶心呕吐及其他不良事件,记录术后首次肛门排气时间,测评术后镇痛满意度。 结果 术后两组患者镇痛优良率均在90%以上,各时点镇痛评分、镇静评分、恶心呕吐发生率、首次肛门排气时间以及患者镇痛优良率差异均无统计学意义(Pgt;0.05)。 结论 术后芬太尼PCSA与PCEA一样,效果确切,对术后胃肠功能无明显影响,患者满意,是一种安全、有效的镇痛方法。【Abstract】 Objective To compare clinical efficiency and gastrointestinal reaction of subcutaneous patient-controlled analgesia (PCSA) and epidural patient-controlled analgesia (PCEA) with fentanyl analgesic for patients after operation. Methods A total of 120 patients having undergone transabdominal hysterectomy under epidural anesthesia between January and June 2009 accepted PCSA or PCEA after operation. We evaluated the state of analgesia and sedation at the 4th, 8th, 12th, 24th and 48th hour after operation. We also looked into the respiration, blood circulation, nausea, vomiting and other abnormal events of the patients during the first 48 hours after operation. At the same time, we recorded the first time of anal exsufflation after operation and the degree of patients’ satisfaction. Results The analgesic effective rate was higher than 90% in both groups. There were no significant differences in analgesia and sedation scores at above-mentioned points after operation, incidence of nausea and vomiting, first time of anal exsufflation or analgesic effective rate between the two groups. Conclusion PCSA with fentanyl can be as effective in relieving postoperative pain as PCEA with fentanyl without obvious adverse effect in the gastrointestinal function. Therefore, PCSA is a safe and effective method to alleviate postoperative pain.

    Release date:2016-09-08 09:24 Export PDF Favorites Scan
  • 自膨式金属支架对恶性气道疾病的疗效及影响术后生存的因素分析

    目的 探讨自膨式金属支架(self-expandable metallic stent,SEMS)治疗恶性气道疾病的疗效及影响支架置入术后生存的因素。方法 2020年2月—2022年6月在广安市人民医院住院治疗的恶性气道疾病患者,根据CSCO指南对患者进行抗肿瘤治疗的基础上,行SEMS置入治疗,收集患者的临床资料。数据用SPSS 23.0进行分析。P<0.05具有统计学意义。结果 共纳入54例患者,其中恶性中央气道狭窄(malignant central airway obstruction,MCAO)40例和恶性气管食管瘘(malignant tracheoesophageal fistula,MTEF)14例;咳嗽和呼吸困难为主要的临床表现;最常见的原发疾病为食管鳞状细胞癌、其次为肺鳞状细胞癌;合并肺炎的患者占87%,痰培养中最常见的病原菌为革兰阴性杆菌,其次为真菌。共置入支架58枚,其中直筒支架42枚、Y型支架16枚;支架置入后,气道狭窄程度较支架置入前明显改善,气促分级明显低于支架置入前,第一秒用力呼气容积明显高于支架置入前(P<0.05);SEMS置入后症状改善率为94.4%;3个月后总生存率为70.4%。多因素分析显示C反应蛋白浓度[OR=1.011,95%CI(1.001~1.020),P=0.016]为SEMS置入3个月后恶性气道疾病死亡的独立危险因素,白蛋白水平[OR=0.883,95%CI(0.781~0.997),P=0.045]为保护性因素。结论 SEMS在恶性气道疾病姑息性治疗中起着重要作用;支架置入前感染的有效控制、营养状况的改善对术后生存有利。

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