目的：观察氟比洛芬酯复合阿片类药物用于妇科开腹术后静脉自控镇痛的临床效果及对比研究。方法：选择妇科行开腹手术患者90例，随机分为三组，每组30例。布托啡诺组（B组）持续量：布托啡诺6mg＋氟比洛芬酯90mg＋托烷司琼6mg＋生理盐水至100ml；吗啡组（M 组）持续量：吗啡30mg＋氟比洛芬酯90mg＋托烷司琼6mg＋生理盐水至100ml；氟比洛芬酯组（F组）持续量：氟比洛芬酯120mg＋托烷司琼6mg＋生理盐水至100ml ，三组患者术毕时均静脉注射氟比洛芬酯60mg作为负荷剂量，然后连接PCIA泵。术后6、12、24、48h监测HR、MAP、RR和sPO2，分别于术后6、12、24、48h记录镇痛评分（VAS评分）、PCA按压次数、恶心呕吐评分、瘙痒评分及呼吸抑制等不良反应。结果：三组患者V A S评分：布托啡诺组（B组）和吗啡组（M 组）与氟比洛芬酯组（F组）相比有统计学差异，布托啡诺组（B组）和吗啡组（M 组）镇痛效果优于氟比洛芬酯组（F组）；布托啡诺组（B组）与吗啡组（M 组）镇痛效果比较无统计学差异。不良反应发生情况：恶心呕吐与皮肤瘙痒评分均显示，布托啡诺组（B组）和氟比洛芬酯组（F组）明显低于吗啡组（M 组），布托啡诺组（B组）与氟比洛芬酯组（F组）相比无统计学差异。结论：氟比洛芬酯复合布托啡诺用于妇科开腹术后镇痛效果确切，恶心呕吐、皮肤瘙痒、呼吸抑制等副作用发生率低，更适用于妇科开腹术后静脉自控镇痛。%Objects :The observed the flurbiprofen axetil composite opioids for controlled analgesia after gynecological laparotomy clinical efficiency and comparative study .Method:Select Chang’an Hospital gynecological surgery Randomly divided into three groups ,Butorphanol group (B ) ,sustained amount :butorphanol 6mg + flur-biprofen axetil The 90mg + tropisetron 6mg to 100ml ,load amount :butorphanol 1mg to 5ml;Morphine group (M group ) ,Sustained amount :morphine 30mg + flurbiprofen axetil 90mg + tropisetron 6mg to 100ml ,morphine 5mg loading dose :To 5ml;The flurbiprofen axetil group (F group) ,sustained amount :flurbiprofen axetil 120mg+ tropisetron 6mg To 100ml ,the three groups of patients who were intravenous flubiprofen ester 60mg dose as a load ,then connect the PCIA pump .6 ,12 ,24 and 48 hours after surgery to monitor HR ,BP ,RR and sPO2 ,6 ,12 , 24 and 48 hours respectively after record pain scores ,PCA pressing times rated Adverse reactions of nausea and vomiting score ,pruritus score and respiratory depression .Result :Three groups of the analgesic rated using a visual analog scale:6 ,12 ,24 and 48 hours after the butorphanol group and morphine group and flurbiprofen axetil group significant difference ,butorphanol group and the analgesic effect of morphine group was superior to the flurbiprofen axetil group .Butorphanol group and the analgesic effect of morphine group no significant difference .Adverse reac-tions occur :nausea and vomiting and skin pruritus score were shown :butorphanol group and flurbiprofen axetil group ,significantly lower than morphine group ,butorphanol group ,and fluorine than the ibuprofen ester group there was no significant difference .Conclusion:Exact butorphanol flurbiprofen axetil for gynecological laparotomy postoperative analgesic effect ,nausea ,vomiting ,skin itching ,respiratory depression ,a low incidence of side effects ,and more suitable for gynecological laparotomy postoperative intravenous analgesia .
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