硬膜外镇痛和肋间神经冷冻镇痛对开胸术后肺功能恢复的影响  

Comparison of intercostals nerve cryoanalgesia with epidural analgesia for post-thoracotomy Pulmonary function

作　　者：安海燕[1] 冯艺[1] 杨拔贤[1] 鞠辉[1] 王俊[1] 彭洁[1] 查鹏[1] 潘芳[1] 

机构地区：[1]北京大学人民医院,北京100044

出　　处：《中国医刊》2009年第3期25-26,共2页Chinese Journal of Medicine

摘　　要：目的比较硬膜外镇痛和肋间神经冷冻镇痛对开胸术后肺功能恢复的影响。方法40例择期后外侧开胸手术的患者,随机分为硬膜外组(E组,n=20)和肋间神经冷冻组(C组,n=20)。术毕E组接硬膜外病人自控镇痛泵。C组于关胸前行切口、上下各一肋间以及胸引管处肋间神经冷冻(-70℃,90秒)。检测术前、术后第1天、第3天、第5天、第7天时FVC、FEV1和PEF。结果与术前相比,两组患者术后FVC、FEV1、PEF均下降。术后第1天、第3天两组差异无统计学意义,而第5天、第7天E组优于C组。结论硬膜外镇痛可明显改善术后肺功能,是一种较好的术后镇痛方法。Objective To compare the post-thoracotomy pulmonary function using epidural analgesia or intercostal nerve cryoanalgesia. Methods Forty adult patients undergoing elective thoracotomy were allocated randomly to receive thoracic epidural analgesia or intercostal nerve cryoanalgesia. The forced vital capacity （ FVC）, forced expira- tory volume in 1 s （FEV1） and peak expiratory flow （PEF）were measured on the day before operation and on the 1 st, 3rd,Sth and 7th postoperative days. Results Compared with pre-operation, FVC, FEV1 and PEF all decreased. Epidural analgesia group led to a significant increase when compared with cryoanalgesia group in FVC, FEV1 and PEF on the 5th and 7th postoperative days. Conclusions The epidural analgesia led to the best restoration of pulmonary function after thoracotomy.

关 键 词：硬膜外镇痛 肋间神经冷冻 肺功能 

分 类 号：R563.4[医药卫生—呼吸系统]