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目的探讨早期使用止痛剂盐酸哌替啶(杜冷丁)对急腹症疼痛缓解、体格检查和诊断准确性等方面的影响。方法对2006年1~12月第二军医大学附属长征医院普通外科急诊经治的107例急腹症进行随机、前瞻、对照临床试验,入选病例按照分层随机法依初次疼痛评分为1~5分和6~10分而分为2层,并分别按随机数表法分为试验组和对照组,观察早期使用杜冷丁后疼痛评分的变化、体格检查的变化情况和诊断准确率。结果(1)试验组中2mL和1mL剂量,给药后病人的平均疼痛评分明显<给药前(P<0.05);对照组中2mL剂量给药前后比较差异无显著性意义(P>0.05),1mL剂量比较差异无显著性意义(P<0.05);给药前后试验组平均疼痛评分差值明显>对照组(P<0.05)。(2)在诊断准确率上和体格检查变化情况上,试验组和对照组比较差异均无显著性意义(P>0.05)。结论早期止痛可以有效缓解急腹症疼痛,没有证据证明会对体格检查和诊断准确性造成影响。
Objective To investigate the effects of early use of pethidine hydrochloride (budesonide), a painkiller, on pain relief, physical examination and diagnostic accuracy of acute abdomen. Methods Randomized, prospective and controlled clinical trials of 107 cases of acute abdomen in general surgery of Changzheng Hospital affiliated to the Second Military Medical University from January to December 2006 were conducted. According to stratified randomized method, the initial pain scores were 1 ~ 5 Points and 6 to 10 points and divided into two layers, and were randomly divided into experimental group and control group according to random number table method to observe the changes of pain score after early use of dolantin, changes in physical examination and diagnostic accuracy. Results (1) The average pain scores of patients in the experimental group after 2 and 1 mL doses were significantly lower than those before administration (P <0.05). There was no significant difference in the 2 mL dose before and after administration (P> 0.05) (P <0.05). The difference of average pain scores in experimental group before and after treatment was significantly higher than that in control group (P <0.05). (2) There was no significant difference between the experimental group and the control group in diagnostic accuracy and physical examination (P> 0.05). Conclusion Early pain relief can effectively relieve the pain of acute abdomen. There is no evidence to prove that it will affect the physical examination and diagnostic accuracy.