联合方法镇痛在痔病术后的临床应用  

Postoperative Application of Combined Analgesic Therapy after Hemorrhoidal Surgical Treatment

作　　者：李贵信[1] 辛学知[1] 夏建光[2] 

机构地区：[1]山东省德州市人民医院肛肠科,山东德州253014 [2]山东省德州市人民医院麻醉手术科,山东德州253014

出　　处：《中国肛肠病杂志》2006年第11期29-32,共4页Chinese Journal of Coloproctology

摘　　要：为了探讨硬膜外缓释镇痛联合局部应用长效止痛剂用于痔病术后镇痛的效果、安全性和可行性，将100例痔病患者随机分成3组：A组（联合方法镇痛组33例）术后采用硬膜外缓释镇痛泵（PCEA泵）联合术后局部应用复方亚甲蓝液镇痛；B组（硬膜外缓释镇痛组32例）术后应用PCEA泵镇痛；C组（局部长效麻醉镇痛组35例）手术后局部应用复方亚甲蓝液镇痛。观察指标包括：生理指标，疼痛，镇痛治疗的满意度，术后不良反应和并发症。各时点疼痛评分结果，说明手术后早期（24h内）应用镇痛泵镇痛效果明显。术后24～72h联合方法镇痛效果最明显，而单纯应用硬膜外镇痛泵镇痛效果最差，局部应用长效镇痛剂镇痛效果尚可。结果表明，联合方法镇痛用于肛门病术后镇痛效果显著．优于单模式的镇痛方法，且具有安全性。实施镇痛时应注意加强护理监测，重视术后的疼痛评估，预防和及时处理不良反应及并发症，进一步提高镇痛治疗效果和安全性，The objective of the study was to investigate the analgesic efficacy,safety and feasibility of epidural delayed-released analgesia combined with long-term analgesics after hemorrhoidal surgical opera tions. Hundred patients with hemorrhoids were divided randomly into .3 groups. Patients in group A （33 cases） received epidural delayed-released（pumped） analgesics plus local application of methylene blue compound for analgesia,patients in group B（32 cases） received epidural delayed released（pumped） analgesics, and patients in group C （35 cases） received local long-term analgesic methylene blue compound,all postoperatively. The indexes for evaluation included physical aspects, pain extents, satisfaction, postoperative adverse reactions and complications. Time period score showed that epidural delayed released（pumped） analgesia was better during the postoperative 24 hours;epidural delayed-released（pumped） analgesia plus local methylene blue compound analgesia was the most satisfactory therapy, while single epidural delayed-released（pumped） analgesia was poor,and local administration of long-term analgesia was moderate during postoperative 24-72 hours. It is concluded that the combined analgesic therapy is better in terms of efficacy and safety,and that attention should be taken in the aspects of nursing,pain scoring,prevention of adverse reaction and complications.

关 键 词：痔 手术 镇痛 

分 类 号：R971.2[医药卫生—药品]