目的 探讨中重度烧伤患儿应用双氯芬酸钠镇痛后对患儿生命征及对应激反应的影响.方法 选择中重度烧伤患儿100例,入院后将其随机分为镇痛组(A 组)和对照组(B 组),每组50例.A 组患儿入院后给予1 mg/kg 双氯芬酸钠栓剂应用,12 h 后重复给予等量药物,每日2 次,持续6 d;B 组除不给予双氯芬酸钠治疗,其他治疗与A 组相同.观察两组各时间点体温、脉搏、呼吸、平均动脉压、心率和脉搏氧饱和度的变化,并抽血测定血浆皮质醇和β-内啡肽的浓度.结果 入院后12 h 到入院后3 d,A 组患儿体温、平均动脉压和心率明显比B 组低,差异有统计学意义(P < 0.05),而其他时间点的比较差异无统计学意义(P > 0.05).烧伤后A 组患儿血浆皮质醇浓度入院后24 h 内明显比B 组低,差异有统计学意义(P < 0.05),A 组患儿血浆β-内啡肽浓度入院后3 d 时间点明显比B 组低,差异有统计学意义(P < 0.05),而其他时间点血浆皮质醇和β-内啡肽浓度的比较差异无统计学意义(P > 0.05).结论 双氯芬酸钠能有效缓解患儿烧伤所产生的应激反应,能维持生命体征的平稳,是患儿烧伤疼痛治疗的较好的方法之一.%Objective To explore the analgesic effect of Diclofenac Sodium on the vital sign and stress reaction in children with moderate and severe burn. Methods 100 children with moderate and severe burn were randomly divided into anal gesic group (group A) and control group (group B), each group had 50 cases. The children in group A were received 1 mg/kg Diclofenac Sodium Suppositories. Later, the same doses of drugs were given to the children after 12 h, twice a day, which lasted 6 days. The children in group B were given no Analgesic, the other treatments were same with group A. The vital signs such as temperature, pulse, respiration, mean arterial pressure, heart rate and pulse oxygen saturation were measured and the plasma concentrations of Cortisol and P-endorphin in 6 days were assayed after admission. Results The temperature, mean arterial pressure and heart rate from 12 h to 3 d in group B were significantly higher than those in group A (P < 0.05), which became similar 3 days later (P > 0.05). The concentrations of Cortisol in group B were significantly higher than those in group A within 24 h (P < 0.05), so did the concentrations of P-endorphin in 3 days (P < 0.05). There showed no statistical differences in the concentrations of Cortisol and P-endorphin in the other times (P > 0.05). Conclusion Diclofenac Sodium can effectively relieve stress reaction and maintain stable vital signs in children with moderate and severe burned. It may be a better analgesic method in pediatric pain of burning.
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