目的 分析四川大學華西醫院麻醉性鎮痛藥應用的現狀及趨勢，并行客觀評價。 方法 對2008年－2010年四川大學華西醫院麻醉性鎮痛藥品的種類、用量、金額、用藥頻度等進行歸類統計、比較和分析。 結果 住院部使用麻醉藥品的用量及金額呈上升趨勢。臨床應用以芬太尼類居首。新型麻醉藥品的應用也有上升趨勢。 結論 麻醉性鎮痛藥的應用基本合理，但創建無痛醫院仍需進一步完善，并提交合理用藥水平。
Objective To study the causes of abdominal distension in patients with hepatocellular carcinoma (HCC) after laparoscopic hepatectomy, and to explore the corresponding treatment countermeasures. Methods A total of 186 patients with HCC were treated by laparoscopic hepatectomy in our hospital from September 1, 2018 to August 31, 2020. Demographic characteristics [age, gender, body mass index (BMI), liver cirrhosis, child-Pugh classification of liver function], operative time, hilar occlusion time, intraoperative blood loss, scope of hepatectomy, postoperative visual analogue scale (VAS) score and serological indexes (hemoglobin, serum albumin, white blood cell count, platelet count, serum potassium level) were collected retrospectively. The occurrence of postoperative abdominal distension was observed, and the patients were divided into abdominal distension group and non abdominal distension group. The independent influencing factors of abdominal distension after laparoscopic hepatectomy were analyzed, and the corresponding treatment countermeasures were discussed. Results A total of 138 patients developed varying degrees of abdominal distension after operation (74.19%), including 45 cases of mild abdominal distension, 53 cases of moderate abdominal distension, and 40 cases of severe abdominal distension. They were all included in the abdominal distension group, and the occurrence time of abdominal distension was mainly 1-5 days after operation. Forty-eight patients (25.81%) had no abdominal distension after operation and were included in the non-abdominal distension group. Univariate analysis results show that: the proportion of patients with abdominal distension combined with liver cirrhosis was significantly higher than that of the non-abdominal distension group (47.10% vs. 25.00%, P=0.007), the operative time [(143.54±23.48) min vs. (129.45±24.51) min, P=0.001], hilar occlusion time [(18.02±8.12) min vs. (15.38±7.28) min, P=0.048] were significantly longer than those of the non-abdominal distension group, the postoperative VAS score was significantly higher than that of the non-abdominal distension group [5.12±1.14 vs. 4.47±1.05, P=0.004], and the serum potassium level was significantly lower than that of the non-abdominal distension group [(3.12±0.38) mmol/L vs. (3.67±0.42) mmol/L, P＜0.001]. Multivariate unconditional logistic regression analysis showed that patients with liver cirrhosis [OR=1.520, 95%CI (1.104, 2.093), P=0.010], serum potassium level ＜3.40 mmol/L [OR=1.684, 95%CI (1.203, 2.357) , P=0.002], operative time ＞136 min [OR=1.842, 95%CI (1.297, 2.616) , P=0.001], hilar occlusion time ＞16.7 min [OR=1.492, 95%CI (1.047, 2.126) , P=0.027], VAS score ＞5 [OR=1.498, 95%CI (1.021, 2.198), P=0.039] were independent risk factors of abdominal distension after laparoscopic hepatectomy. Conclusions The risk factors of abdominal distension after laparoscopic hepatectomy were liver cirrhosis, serum potassium level ＜3.40 mmol/L, operative time ＞136 min, hilar occlusion time ＞16.7 min and VAS score ＞5. More attention should be paid to high-risk patients and effective treatment measures should be taken in time to reduce the risk of abdominal distension after surgery. For patients with abdominal distension, we should take effective measures to alleviate the symptoms of abdominal distension and promote the recovery of patients with abdominal distension.
目的 研究環氧合酶-2抑制劑藥物的應用狀況和發展趨勢，為臨床合理、有效、經濟地選用藥物提供科學依據。 方法 采用金額排序和用藥頻度（DDDs）、日均費用（DDC）方法，對四川大學華西醫院2008年－2010年環氧合酶-2抑制劑藥物的臨床應用情況進行統計分析。 結果 2008年－2010年間，該院環氧合酶-2抑制劑藥物的應用數量和銷售金額呈逐年上升趨勢，其中選擇性環氧合酶-2抑制劑藥物的用量增幅較大，非選擇性環氧合酶-2抑制劑藥物用量呈下降趨勢。 結論 該院環氧合酶-2抑制劑藥物臨床應用合理，選擇性環氧合酶-2占主導地位，有較好的發展前景。