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目的探讨切削痂植皮术后首次换药烧伤患者行丙泊酚联合瑞芬太尼镇静镇痛的效果。方法选取2013年2月至2015年6月东莞康华医院收治的切削痂植皮术后首次换药患者100例为研究对象,按随机数字表法将其分为对照组和观察组,每组50例。对照组患者换药前静脉注射丙泊酚,观察组患者换药前给予丙泊酚联合瑞芬太尼,比较两组患者疼痛程度、Ramsay镇静评分、治疗满意度及不良反应发生情况。结果换药即刻、换药开始后10、20、30 min及换药结束,观察组患者的疼痛视觉模拟量表(VAS)评分均明显低于对照组,Ramsay镇静评分明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者的治疗满意度明显高于对照组,差异有统计学意义(P<0.05)。结论烧伤切削痂植皮术后首次换药患者应用瑞芬太尼联合丙泊酚,镇静镇痛效果明显,能保留患者意识及自主呼吸,提高满意度,不良反应少,安全性高。
Objective To investigate the analgesic effect of propofol combined with remifentanil in the first dressing-burn patients after cutting-skin grafting. Methods From February 2013 to June 2015, 100 patients with the first dressing change after cutting crust grafting in Dongguan Kanghua Hospital were selected as the research objects. According to the random number table, they were divided into control group and observation group, with 50 example. The patients in the control group were given propofol intravenously before the dressing change. The patients in the observation group were given propofol combined with remifentanil before dressing change. The pain level, Ramsay sedation score, treatment satisfaction and adverse reactions were compared between the two groups. Results Immediately after dressing change, the pain visual analog scale (VAS) scores of the observation group were significantly lower than those of the control group at 10, 20, 30 min after dressing change and the end of dressing change, and the Ramsay sedation score was significantly higher than that of the control group (All P <0.05). The treatment satisfaction of observation group was significantly higher than that of control group, the difference was statistically significant (P <0.05). Conclusion Remifentanil and propofol are used in the first dressing change after burns and cutaneous grafting. The sedation and analgesic effect is obvious, which can keep patients’ awareness and spontaneous breathing, increase satisfaction, less adverse reactions and high safety.