帕瑞昔布钠超前镇痛对乳腺癌根治术患者血小板及凝血功能的影响

[目的]研究帕瑞昔布钠超前镇痛对乳腺癌根治术患者血小板及凝血功能的影响.[方法]选择ASAⅠ-Ⅱ级择期行乳腺癌根治术患者40例,随机分为帕瑞昔布钠组(A组,n=20)和生理盐水组(B组,n=20).A组在麻醉诱导前10 min给予帕瑞昔布钠40mg+生理盐水4ml静脉注射,B组在麻醉诱导前10 min给予生理盐水4ml静脉注射,术后均予喷他佐辛自控镇痛(PCA).分别记录两组患者清醒即刻(T0)、术后2 h(T1)、4 h(T2)、6 h(T3)、8h(T4)、12 h(T5)及24 h(T6) VAS评分和Ramsay镇静评分.两组患者分别在术前和静脉注射试验药物后60min抽取静脉血,测定血小板聚集率、凝血酶原时间(PT)、凝血酶时间(TT)、激活部分凝血酶原时间(APTT)和纤维蛋白原浓度(Fib).[结果]两组病例术后24h内Ramsay镇静评分的差异无统计学意义(P＞0.05),A组VAS评分低于B组,差异有统计学意义(P＜0.05).两组患者术前和给药后60 min血小板聚集功能及凝血功能比较差异无统计学意义.[结论]与单独应用喷他佐辛术后镇痛相比,帕瑞昔布钠超前镇痛用于乳腺癌根治术患者的效果更确切且不影响患者的血小板和凝血功能.

Influence of preemptive parecoxib on platelet function and blood coagulation function in patients of radical excision of breast cancer

Objective To investigate the effect of preemptive parecoxib on platelet function and blood coagulation in patients of radical excision of breast cancer.Methods Forty ASAⅠ-Ⅱpatients were randomized to one of 2 groups(n=20 each):parecoxib group(group A)received intravenous parecoxib 40 mg/4 ml at 10 min before anesthesia and control group(group B)received normal saline 4 ml instead of parecoxib.Both patients received patient-controlled analgesia(PCA)with pentazocine after surgery.VAS scores and Ramsay scores were recorded at 0 h,2 h,4 h,6 h,8 h,12 h,24 h(T0-6)after surgery.Venous blood samples were taken at 1 h after parecoxib or normal saline administration for platelet function and blood coagulation function.Results Compared with group B VAS scores at T0-6 were all decreased in group A(P<0.05).There were no significant difference in Ramsay score,platelet function and blood coagulation function between the 2 groups(P>0.05).Conclusions Preemptive parecoxib can effectively relieve postoperative pain and have not significant effects on platelet function and blood coagulation function in patients of radical excision of breast cancer.