开胸术后常用镇痛方法的对比分析  

COMPARATIVE ANALYSIS ON ANALGESIA FOR POST-THORACOTOMY PAIN

作　　者：贺钢枫[1] 何斌[2] 李简[3] 

机构地区：[1]包头市中心医院胸外科,内蒙古包头014040 [2]包头市第三医院检验科 [3]北京大学第一医院胸外科

出　　处：《内蒙古医学院学报》2007年第1期23-25,共3页Acta Academiae Medicinae Neimongol

摘　　要：目的:评价医师控制镇痛(DCA)、病人自控硬膜外镇痛(PCEA)和病人自控静脉镇痛(PC IA)对开胸术后疼痛的治疗效果。方法:将开胸术后病人33例随机平均分入DCA组、PCEA组、PC IA组。采用疼痛视觉模拟评分法评定上述三组病人的术后疼痛,并观察与镇痛有关的副作用。结果:开胸术后48h内平静状态时,DCA组病人的疼痛积分高于PCEA及PC IA组(P<0.05);术后24h时内咳嗽时,DCA组病人的疼痛积分高于PCEA组(P<0.05);术后24h后咳嗽时三组间病人的疼痛评分无显著差异(P>0.05);开胸术后任何时段PCEA与PC IA两组间病人疼痛评分无显著差异(P>0.05)。三组间与疼痛和镇痛有关的并发症发生率无显著性差异(P>0.05)。结论:PCEA和PC IA对开胸术后早期疼痛有较理想的治疗效果。Objective： To assess the curative effectiveness of doctor - controlled analgesia （DCA） （ pain relief according to their requisition）, patient - controlled epidural analgesia （ PCEA）, and patient - controlled intravenous analgesia （PCIA） for post - thoraeotomy pain. Methods： 33 post - thoraeotomy patients were divided into DCA, PCEA and PCIA groups. By means of visual analogue scale, severity of post - thoraeotomy pain and curative effectiveness of various modalities of analgesia were assessed. Results： Compared with ＂the patients who received DCA, the patients receiving PCEA and PCIA experienced less pain within 48 hours after thoracotomy. When coughing 24 hours after thoracot- omy, patients receiving DCA experienced more pain that those receiving PCEA and PCIA （P 〈 0. 05 ）. There is no statistical difference of complication related to post - thoracotomy pain analgesia between three groups 24 hours after thoracotomy. Conclusion：Both PCEA and PCIA showed an ideal curative effectiveness for post -thoracotomy pain control.

关 键 词：开胸术后 疼痛 镇痛 

分 类 号：R655.1[医药卫生—外科学]