局部镇痛泵在经腹全子宫切除术中的应用  

Applications of local analgesia in total abdominal hysterectomy

作　　者：刘锦霞[1] 张永[1] 李美玲[1] 吴元赭[1] 

机构地区：[1]南京军区南京总医院妇产科,南京市210002

出　　处：《中华全科医学》2014年第2期208-209,281,共3页Chinese Journal of General Practice

摘　　要：目的回顾经腹子宫全切术后使用局部镇痛装置镇痛的安全性和有效性。方法选取2010年3月--2012年3月妇科恶性肿瘤手术治疗患者60例，均行经腹子宫全切术，年龄31～58岁，平均47．8岁。60例患者年龄、肿瘤分期、手术过程等参数均相似，分为实验组与对照组，每组各30例，实验组在围手术期使用术后持续伤口镇痛装置进行局部镇痛处理，记录围手术期不同时间点疼痛视觉模拟评分VAS和应用不良并发症情况。对每个接受治疗的患者进行回顾性分析，数据包括疼痛评分以及阿片药物在术后3天的使用情况。结果实验组与对照组相比，术后3天内阿片药物使用量明显下降。使用局部镇痛装置的患者平均疼痛评分在术后1～3天均有所降低（P〈0．05），患者并发症的发生率较低（x2=33．01，P〈0．05）。结论接受局部镇痛装置的患者在术后3天内减少了阿片药物的使用量并且降低疼痛评分。在经腹进行妇科恶性肿瘤手术治疗后，采用持续伤口镇痛装置用于围术期镇痛可以改善术后镇痛效果和减少阿片类药物使用量。Abstract： Objective To evaluate the feasibility and safety of local analgesia device used in the surgery of total abdomi- nal hysterectomy in the treatment of endometrial cancer. Methods From March 2011 to March 2011,60 patients suffer- ing endometrial cancer were treated with the surgeries of total abdominal hysterectomy. They were at age of 31 -58 years （average 47.8 years）. All the patients were diagnosed gynecologic malignant tumor by tissue biopsy. According to age, tumor stage, surgical procedure parameters, all the patients were divided into test group and control group, and each group had 30 patients. For the test group patients we used local analgesia device in perioperative period, and for the control group we did not. VAS and bad complications were recorded at different time. With retrospectively analyze our data includ- ed pain scores and opioid-use after 3 days. Results Compared with the control group, dose of opioid drug used in test group declined in the first three days after operation. The VAS of patients using local analgesia device score in 1 - 3 days after operation decreased. There was significant statistical difference in complications occurring（ P 〈 O. 05 ）. Conclusion Local analgesia device used in the surgery of total abdominal hysterectomy in the treatment of endometrial cancer can be a safe and feasible method.

关 键 词：子宫切除术 围手术期 镇痛 术后持续伤口镇痛装置 临床疗效 

分 类 号：R713.4[医药卫生—妇产科学] R61[医药卫生—临床医学]