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目的观察氟比洛芬酯(FPA)联合地塞米松超前镇痛用于尘肺病大容量肺灌洗的临床效果。方法采用随机数字表法,将90例需行大容量肺灌洗的尘肺病患者随机分为联合给药组、FPA组和对照组,每组30例。联合给药组患者术前2 h静脉注射2 mg/kg体质量FPA注射液与10 mg地塞米松,FPA组患者术前静脉注射2 mg/kg体质量FPA注射液,对照组患者术前注射0.9%氯化钠溶液2 m L。比较3组患者术后2、6、8、12、24 h的疼痛视觉模拟法评分(VAS)、舒适评分(BCS)及术后24 h不良反应发生情况。结果在术后5个时间点,联合给药组患者VAS和BCS评分均高于对照组和FPA组(P<0.01);联合给药组患者VAS评分呈随着术后时间增加而减少的趋势(P<0.05),BCS评分呈随着术后时间增加而增加的趋势(P<0.05)。联合给药组患者术后24 h恶心呕吐、头晕嗜睡、咽喉痛和皮肤瘙痒的发生率均低于对照组和FPA组(P<0.017)。结论 FPA联合地塞米松超前镇痛是一种安全有效的缓解尘肺病患者大容量肺灌洗术后疼痛的治疗方法。
Objective To observe the clinical effect of flurbiprofen axetil (FPA) combined with dexamethasone preemptive analgesia for pulmonary lavage with large capacity. Methods Ninety patients with pneumoconiosis requiring large-capacity lung lavage were randomly divided into the combined treatment group, FPA group and control group, with 30 cases in each group. Patients in the combination group received 2 mg / kg body weight FPA injection and 10 mg dexamethasone intravenously 2 h before the operation. Patients in the FPA group received 2 mg / kg body weight FPA injection before operation and patients in the control group received preoperative injection 0.9% sodium chloride solution 2 m L. The pain visual analogue scale (VAS), comfort score (BCS), and the incidence of adverse reactions at 24 h after operation were compared between the two groups at 2, 6, 8, 12 and 24 h after operation. Results At 5 postoperative time points, the VAS and BCS scores of the combination group were higher than those of the control group and the FPA group (P <0.01). The VAS score of the combination group decreased with the increase of postoperative time (P <0.05). BCS score increased with the increase of postoperative time (P <0.05). The incidence of nausea, vomiting, dizziness, drowsiness, sore throat and pruritus occurred in 24 h after operation in the combination group were significantly lower than those in the control group and the FPA group (P <0.017). Conclusion FPA combined with dexamethasone advanced analgesia is a safe and effective treatment for patients with pneumoconiosis after massive lavage.