冷冻肋间神经对开胸术后止痛的临床观察  

Clinical observation on the analgesic effect by freezing intercostal nerve after thoracotomy

作　　者：石彦涛[1] 王有富[1] 周连亚[1] 李永军[1] 刘瑞林[1] 李书军[1] 

机构地区：[1]河北医科大学第二医院胸外科,石家庄市050000

出　　处：《疑难病杂志》2007年第9期531-533,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省科技攻关指导项目(课题编号:072761128)

摘　　要：目的观察冷冻肋间神经后对开胸术后止痛的效果,并与术后静脉自控镇痛泵止痛的效果进行对比。方法随机选取开胸术后的患者58例为冷冻组(术中冷冻肋间神经);随机选择同期行开胸手术的患者49例为对照组(术后静脉自控镇痛泵),观察2组患者术后疼痛及止痛药的使用情况,同时观察术后3个月伤口周围的感觉情况。结果冷冻组止痛的总有效率(94.8%)与对照组(65.3%)相比差异有统计学意义(P<0.05)。冷冻组术后应用曲马朵4例(6.9%),对照组12例(24.5%),2组比较差异有统计学意义(P<0.05)。结论术中冷冻肋间神经有较好的术后镇痛效果,可减少术后止痛药的用量,较静脉自控镇痛泵止痛方法简便易行,效果更佳。Objective To observe the analgesic effect by freezing intercostal nerve after thoracotomy, and to compare the efificacy with the conventional patient-controlled intravenous analgesia （PCIA） after thoracotomy. Methods 58 patients underwent thoracotomy were randomly selected as trail group （to freeze intercostal nerve during operating） ;49 patients underwent thoracotomy were randomly selected as control group （to use PCIA after thoracotomy）, then the analgesic effect and the application of analgesic drugs were observed in both groups. At the same time, patients＇ feeling of periwound after 3 months were observed. Results The total effective rate of analgesia in freezing group was significantly higher than that of control group （94.8 % vs 65.3 %, P 〈 0.05 ）. 4 patients in freezing group and 11 patients in control group took tramadol, there was a significant difference between the two groups （ P 〈 0.05）. Conclusion The analgesic effect by freezing intercostal nerve during the operation is satisfactory, which could reduce the dosage of analgesic drugs after thoracotomy, with better analgesic effect and simple application, as compared with PCIA.

关 键 词：冷冻 肋间神经 开胸术 静脉自控镇痛 

分 类 号：R614.4[医药卫生—麻醉学] R655[医药卫生—外科学]