食管癌术后冷冻肋间神经镇痛的临床疗效观察  

Clinical Observation of Frozen Intercostals Nerve Analgesia after Esophagectomy

作　　者：梁冰[1] 张挚[1] 赵辉[1] 李晓辉[1] 李勇[1] 施巩宁[1] 

机构地区：[1]河南大学淮河医院,河南开封475000

出　　处：《中国医学创新》2014年第13期24-26,共3页Medical Innovation of China

摘　　要：目的:评价食管癌术后应用肋间神经冷冻镇痛的临床效果。方法:选取2010年2月-2012年6月本科收治的157例食管癌患者,按照随机数字表法将其分为三组,肋间神经冷冻组(n=65):采用术中冷冻肋间神经止痛,每根肋间神经冷冻温度为-57℃左右,冷冻时间为90 s;镇痛泵组(n=51):术后由麻醉师给予静脉用镇痛泵(舒芬太尼)止痛;对照组(n=41):临时肌注吗啡。通过视觉模拟疼痛评分法评价术后疼痛程度,比较各组肺部并发症发生率及第1秒用力呼气容积(FEV1)实测值,同时比较各组胃肠道功能恢复时间。结果:肋间神经冷冻组的术后镇痛效果、肺部并发症、胃肠道排气排便情况等方面均明显优于镇痛泵组和对照组,差异均有统计学意义(P<0.05)。结论:肋间神经冷冻术可明显减轻食管癌患者开胸术后疼痛,且能降低并发症发生率,可作为常规选择替代人工镇痛泵。Objective：To evaluate the clinical effect of intercostals nerve freezing analgesia after esophagectomy for patients.Method：157 patients with esophageal carcinoma were selected in our department from February 2010 to June 2012,they were were randomly divided into three groups.Intercostal nerve cryoanalgesia group（n=65）：it was treated with freezing intercostal nerve pain in surgery,each root intercostals nerve freezing temperature was about -57 ℃,the freezing time was 90 s.Analgesia pump group（n=51）：it was treated with intravenous analgesia pump （sufentanil）to stop the pain by anesthesiologist after the surgery.The control group （n=41）：intramuscular injection of morphine.The degree of postoperative pain was evaluated through visual analog pain score method,pulmonary complications and forced expiratory volume in 1 second （FEV1） measured values were compared in three groups,and the gastrointestinal function recovery time were compared.Result：Postoperative analgesia effect,pulmonary complications,pulmonary function, gastrointestinal exhaust and defecation situation in the intercostal nerve cryoanalgesia group were superior to analgesia pump group and the control group,the differences were statistically significant（P〈0.05）.Conclusion：Freezing intercostal nerves can obviously reduce open thoracic esophageal cancer patients postoperative pain,and can reduce the incidence of complications,can be used as a routine alternative artificial analgesia pump.

关 键 词：食管癌切除术 肋间神经冷冻 镇痛 

分 类 号：R735.1[医药卫生—肿瘤] R614[医药卫生—临床医学]