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目的观察N_2O吸入与口服曲马多缓释片在光动力治疗尖锐湿疣术中的镇痛效果。方法将接受光动力(PDT)治疗的尖锐湿疣患者以数字评分法(NRS)对疼痛进行评分,观察并记录PDT照光过程中1min,5min,10min,15min,20min疼痛评分及照光结束后3h,6h,24h,48h及72h疼痛评分。将患者随机分为N_2O组及曲马多组,在第2次光动力治疗过程中分别给予N_2O镇痛及曲马多镇痛:其中N_2O组吸入低浓度笑氧混合气;曲马多组照光前2h口服盐酸曲马多缓释片。结果在照光过程中,N_2O组与曲马多组均具有良好的镇痛效果,与患者的疼痛基础值比较,差异均有统计学意义(P均<0.05),N_2O组优于曲马多组(P<0.05)。照光结束后两组患者疼痛均缓解,术后24h内曲马多组疼痛平均值明显低于N_2O组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05),均未发生严重不良事件。N_2O组患者吸入N_2O前后HR,BP,SpO_2比较,差异无统计学意义(P>0.05)。结论对于光动力治疗过程中疼痛评分NRS>6分的患者,应用N_2O吸入镇痛能更有效的缓解治疗过程中的疼痛,而口服曲马多镇痛则可持续更长时间。
Objective To observe the analgesic effects of N 2 O inhalation and oral tramadol sustained release tablets in the treatment of condyloma acuminatum by photodynamic therapy. Methods Patients with condylomata acuminatum treated with photodynamic therapy (PDT) were scored by numerical score method (NRS). The pain scores at 1, 5, 10, 15 and 20 minutes after PDT were observed and recorded. , 24h, 48h and 72h pain scores. The patients were randomly divided into N2O group and tramadol group. N2O analgesia and tramadol were given respectively during the second photodynamic therapy. The N2O group inhaled low concentration of oxygen and oxygen, and the tramadol group 2h before oral tramadol hydrochloride tablets. Results During the light irradiation, the N_2O group and the tramadol group had good analgesic effects, which were significantly different from those of the patients with pain baseline (P <0.05), while the N_2O group was better than the tramadol group (P <0.05). Pain was relieved in both groups after irradiation, and mean pain scores in tramadol group were significantly lower than those in N2O group within 24h after operation (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05), and no serious adverse events occurred. There were no significant differences in HR, BP and SpO_2 between N 2 O and N 2 O before inhalation (P> 0.05). Conclusions For patients with pain score NRS> 6 during photodynamic therapy, N2O inhalation may be more effective in relieving pain during treatment, whereas oral tramadol may last longer.