林健兴+潘永雄+杨广钢

[摘要]目的 探讨丁丙诺啡透皮贴用于跟骨骨折术后镇痛的临床效果。方法 2015年6月～2016年6月，将我院的100例跟骨骨折术后患者随机分为两组。观察组（50例）使用丁丙诺啡透皮贴进行术后镇痛；对照组（50例）使用硬膜外自控镇痛泵进行术后镇痛。观察比较两组的术后镇痛效果及不良反应。结果 两组患者术后6、12、24、48、72 h及术后第7天的视觉模拟评分（VAS）比较差异均无统计学意义（P>0.05）；观察组的部分术后的不良反应（胃肠道反应、头晕、嗜睡）发生率低于对照组，差异有统计学意义（P<0.05）。结论 与术后使用硬膜外自控镇痛泵比较，丁丙诺啡透皮贴剂用于跟骨骨折术后镇痛效果满意，且不良反应少，值得临床推广应用。

[关键词]丁丙诺啡透皮贴；跟骨骨折；术后镇痛

[中图分类号] R971+.2 [文献标识码] A [文章编号] 1674-4721（2017）08（b）-0120-03

The postoperative analgesic effect of Buprenorphine transdermal patch used after calcaneal fracture surgery

LIN Jian-xing PAN Yong-xiong YANG Guang-gang

Department of Foot & Ankle Orthopedics，Guangzhou Orthopedic Hospital in Guangdong Province，Guangzhou 510045，China

[Abstract]Objective To study the postoperative analgesic effect of Buprenorphine transdermal patch used after calcaneal fractures surgery.Methods 100 cases after calcaneal fracture surgery treated in our hospital from June 2015 to June 2016 were randomly divided into two groups.50 cases in observation group were given Buprenorphine transdermal patch for postoperative analgesia while 50 cases in control group were given epidural controlled analgesia pump for postoperative analgesia.The postoperative analgesic effect and adverse reactions were observed and compared between the two groups.Results VAS score after 6 h，12 h，24 h，48 h，72 h operation and the seventh days after operation in patients between the two groups were no statistical significance（P>0.05）.Postoperative adverse reactions （gastrointestinal reaction， dizziness， drowsiness） in observation group were less than those of the control group，and the differences were statistically significant （P<0.05）.Conclusion Compared with postoperative epidural controlled analgesia pump，the postoperative analgesic effect of Buprenorphine transdermal patch for paitiens with calcaneal fractures is satisfied with less adverse reactions.It is worthy of clinical popularization and application.

[Key words]Buprenorphine transdermal paste；Calcaneal fractures；Postoperative analgesia

跟骨骨折是創伤骨科的常见病之一，约占全身骨折的2%[1]，手术治疗能良好复位骨折端，疗效确切[2]。但由于足踝部皮肤菲薄，手术创伤后常常引起患部再次肿胀，疼痛难忍，并可引起一系列并发症。术后良好的镇痛治疗不仅可提高患者的满意度，并可降低术后相关并发症的风险。目前临床上骨折术后镇痛的方式多种多样，其中丁丙诺啡透皮贴剂由于其镇痛效果确切，持续时间长，不良反应较少，逐渐被应用。本研究别采用丁丙诺啡透皮贴剂与既往常用的硬膜外自控镇痛泵治疗跟骨骨折术后疼痛，比较其效果及不良反应发生情况，现报道如下。

1 资料与方法

1.1一般资料

本研究按照随机、单盲临床对照设计。选取广州市正骨医院2015年6月～2016年6月由高处坠落伤导致的跟骨骨折手术患者共100例，每组50例。患者……