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目的探讨肺癌患者胸腔镜肺叶切除术后分别应用帕瑞昔布钠及地佐辛镇痛的不良反应及效果。方法纳入2015年8月至2016年1月四川大学华西医院胸外科连续收治的行胸腔镜肺叶切除术的非小细胞肺癌患者90例,用随机数字表将患者分为帕瑞昔布钠组(PG组,43例)和地佐辛组(DG组,47例)。分析两组患者术后不良反应、疼痛评分、部位和性质。结果 PG组术后早期恶心、呕吐及腹胀发生率(9.30%,2.33%,13.95%)均低于DG组(25.53%,17.02%,40.43%),且差异有统计学意义(P=0.046,P=0.032,P=0.009)。PG组术后静息状态下12 h、24 h、48 h和72 h镇疼效果(2.56±0.96,2.47±0.96,1.93±0.99,0.98±1.24)均显著优于DG组(4.00±1.60,3.62±1.48,3.36±1.55,2.47±1.78,P=0.000,P=0.000,P=0.000,P=0.002)。同时术后各个时间段咳嗽时镇疼作用在PG组也均优于DG组。两组患者术后疼痛最常见部位均依次是引流管口、手术切口及胸壁;术后疼痛性质均依次是胀疼、刺疼及麻木。结论肺癌患者行胸腔镜肺叶切除术后镇疼应用帕瑞昔布钠不良反应发生率低且效果好。
Objective To investigate the adverse reactions and their effects of parecoxib and dezocine in patients with lung cancer after thoracoscopic lobectomy. Methods Ninety consecutive patients with non-small cell lung cancer underwent thoracoscopic lobectomy underwent thoracoscopic lobectomy in the Department of Thoracic Surgery, West China Hospital, Sichuan University from August 2015 to January 2016. The patients were divided into the parecoxib sodium group PG group, 43 cases) and dezocine group (DG group, 47 cases). Adverse reactions, pain scores, location and nature of the two groups were analyzed. Results The incidence of nausea, vomiting and abdominal distension in the early PG group were significantly lower than those in the DG group (9.30%, 2.33%, 13.95%) (P = 0.046, 17.02%, 40.43% P = 0.032, P = 0.009). The pain relief effect of PG group at 12 h, 24 h, 48 h and 72 h (2.56 ± 0.96, 2.47 ± 0.96, 1.93 ± 0.99, 0.98 ± 1.24) was significantly better than that of DG group (4.00 ± 1.60, 3.62 ± 1.48, 3.36 ± 1.55, 2.47 ± 1.78, P = 0.000, P = 0.000, P = 0.000, P = 0.002). At the same time, the analgesic effect of cough during each time after surgery was also better in the PG group than in the DG group. The most common sites of postoperative pain in both groups were drainage tube, surgical incision and chest wall in turn. The postoperative pain properties were followed by pain, tingling and numbness. Conclusion The incidence of adverse reactions of parecoxib in patients with lung cancer after thoracoscopic lobectomy is low and the effect is good.