目的 分析不同质量浓度罂粟碱预防手外科患者血管痉挛及静脉炎的效果.方法 选择医院2015年2月至2016年1月行手部手术的外科患者68例,按手术顺序编号并随机分为A组和B组,各34例.两组患者均于手术完成后即开始采用输液泵持续泵入罂粟碱防治血管痉挛,两组患者均于6h内泵入60 mg罂粟碱(但质量浓度不同,A组为1.2 g/L,B组为0.6 g/L),每6h换1次,连续6d.结果 两组患者术后24,48,72 h时患指疼痛视觉模拟评分(VAS)比较,差异无统计学意义(P＞0.05);术后1个月内,A组患者并发静脉炎26例(76.47％),明显多于B组患者的14例(41.18％);A组患者静脉炎Ⅲ级比例明显高于B组患者(P＜0.05).结论 低质量浓度罂粟碱静脉泵入用于手外科患者,虽不能明显增强血管痉挛的防治效果,但能有效降低术后静脉炎的发生率,提升患者就医感受,具有较高的临床价值.%Objective To analyze the effect of different concentrations of papaverine in preventing hand vascular spasm and phlebitis in Department of Hand Surgery.Methods Totally 68 patients underwent hand surgery from February 2015 to January 2016 were selected and randomly divided into group A and group B according to the operation sequence number,34 cases in each group.The patients in the two groups used infusion pump to continuous infusion of papaverine in prevention of vasospasm after surgery,the patients in the two groups were pumped into the 60 mg papaverine within 6 h (but with different concentrations,group A:1.2 g/L,group B:0.6 g/L).The patients in the two groups were changed 1 time per 6 h and pumped continuously for 6 d.Results There was no significant difference in VAS score between the two groups at 24,48,72 h after surgery (P ＞ 0.05),within 1 month after surgery,26 cases (76.47％) of phlebitis occurred in group A,which was significantly more than that 14 cases (41.18％) in group B,the proportion of phlebitis(grade m) in group A was significantly higher than that in group B (P ＜ 0.05).Conclusion Infusion of low concentration of papaverine for patients in Department of Hand Surgery,although can't significantly increase the control effect of vasospasm,it can effectively reduce the postoperative incidence of phlebitis and improve the patients' feeling of medical treatment,which has high clinical value.
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