ABSTRACT
Objective To observe the analgesic effect of compound coeruleum methylene blue preparation after thoracoscopic surgery,and to provide a new idea for the choice of analgesic drugs for thoracoscopic patients.Methods The clinical data of 116 patients who underwent selective thoracoscopic surgery in the Department of Cardiothoracic Surgery of Jieyang People's Hospital from January 2016 to May 2018 were analyzed.This study was a prospective study.Research subjects were divided into control group (n =57) and observation group (n =59) by random digital table.In the two groups,no analgesic measures were used in advance,of which the patients in the control group were given the routine injection of piperidine hydrochloride by intramuscular injection after operation.While patients in the observation group were given intercostal nerve block across the upper and lower fibs after operation,and the dosage of compound methylene blue was 1 ml in each rib.on the basis with pethidine hydrochloride.The visual analog score and Ramsay sedation score were compared between the two groups of patients at 4 h,12 h 24 h and 48 h after operation and compared the use of pethidine hydrochloride,adverse drug reactions,ambulation time and hospitalization time.The counting data was expressed in terms of frequency and percentage (％).The measurement data were represented by ((x) ± s).The comparison of different time points within the group was performed by single-factor analysis of variance,and the comparison between the two groups was performed by independent sample t test.Results Compared with the control group's patients [in resting state,12 h:(3.85 ± 1.97) points;24 h:(2.74 ± 1.91) points;48 h:(2.11 ± 1.70) points;in activity state,12 h:(5.02 ± 1.64) points;24 h:(4.89 ± 1.36) points;48 h:(3.83 ± 1.51) points],the VAS scores of the patients in the observation group in resting state [12 h:(2.68 ± 1.24) points;24 h:(1.35 ± 1.16) points;48 h:(0.74 ± 0.63) points] and activity state[12 h:(3.81 ±1.53) points;24 h:(3.25±1.71) points;48 h:(2.42± 1.33)points] were significantly lower at 12 h,24 h and 48h after operation.Compared with the control group's patients 12 h [(2.58 ± 0.41) points] and 24 h [(2.29 ± 0.34) points],the Ramsay scores were significantly higher at 12 h[(2.93 ±0.35)points] and 24 h [(2.79 ±0.30)points] after operation (P＜0.05).The observation group's amount of piperidine hydrochloride was less,and the ambulation and hospitalization time were shorter than the control group's (P ＜ 0.05).The incidence of analgesia-related adverse reactions in the control group and the observation group were 35.09％ and 27.12％,respectively,with no significant difference (P ＞ 0.05).Conclusions Compound coeruleum methylenum's analgesic effect after thoracoscopic surgery is accurate and maintains long time,and the side effects are less and the operation is convenient.It is worthy of clinical application.
ABSTRACT
OBJECTIVE@#To observe the clinical treatment effectiveness of Clarithromycin combined with nasal glucocorticoids for chronic rhinosinusitis (CRS).@*METHOD@#Clarithromycin was 0.25 g a day (the first two weeks was 0.25 g twice a day) and topical Triamcinolone Acetonide Acetate nasal spray was (220 microg/d) once a day. Fifty-six patients were enrolled in our research. Twenty-six patients of CRS without nasal polyps was treated for 12 to 28 weeks (average 16.62 weeks). Thirty patients of CRS with nasal polyps was treated for 12 to 33 weeks (average 20.03 weeks) after polypectomy. The patients' symptom were evaluated through Sino-Nasal Outcome Test 20 (SNOT-20) scale. Meanwhile sinus CT were evaluated by Lund-Mackey system before and after operation.@*RESULT@#The score of CT scan was significantly decreased to 2.83 +/- 1.86 (t = 11.41, P < 0.01) in the CRS with nasal polyps group and to 2.43 +/- 1.91 (t = 12.86, P < 0.01) in the CRS without nasal polyps group after treatment. Recovery rate of CRS with nasal polyps group was 43.3% and of CRS without nasal polyps group was 50.0% with CT images. The self assessments of treatment efficiency was coincident with CT image in the two groups.@*CONCLUSION@#The treatment with Long term use of low dosage oral macrolide Clarithromycin combined with nasal steroid on CRS was efficacy. Polypectomy ,large dose antibiotic and steroid used in intraoperative period could significant improve the treatment efficiency of CRS with nasal polyps.