重症胸外伤患者术后静脉自控镇痛的临床效果观察  

Clinical effect of patient-controlled intravenous analgesia on postoperative patients with severe thoracic trauma

作　　者：刘莉[1] 钟源波[1] 

机构地区：[1]广东省深圳市人民医院麻醉科,深圳市518020

出　　处：《广西医学》2015年第5期646-647,659,共3页Guangxi Medical Journal

基　　金：广东省深圳市科技计划项目(201203134)

摘　　要：目的观察静脉自控镇痛用于重症胸外伤(STT)患者术后镇痛效果。方法将STT患者90例,按随机数字表法分为观察组和对照组,每组45例。两组患者入院后均按通气、输液、搏动、控制出血、手术的程序进行救治,观察组术后给予芬太尼、格拉司琼和氯胺酮行静脉自控镇痛,对照组术后给予芬太尼、格拉司琼和右美托咪定行静脉自控镇痛。比较两组患者术后1 h、6 h、12 h及24 h视觉模拟(VAS)评分、Ramsay镇静(RSS)评分及不良反应发生率。结果观察组患者术后VAS评分低于对照组(P<0.05),两组VAS评分随着时间延长而降低(P<0.05);两组RSS比较,差异无统计学意义(P>0.05)。观察组并发症发生率低于对照组(P<0.05)。结论重症胸外伤患者术后静脉自控镇痛加用氯胺酮能增强镇痛效果,并且未增加并发症的发生率,安全可靠。Objective To observe the analgesic effect of patient-controlled intravenous analgesia on postoperative patients with severe thoracic trauma（ STT） .Methods Ninety STT patients were divided into observation group and control group according to the random number table,with 45 cases in each group.The patients in the two groups received the treatment with procedures of ventilation,infusion, pulsation,bleeding control and operation after the hospitalization.The observation group was given patient-controlled intravenous analgesia of fentanyl,granisetron and ketamine after operation, while the control group received patient-controlled intravenous analgesia of fentanyl, granisetron and dexmedetomidine after operation.The visual analogue scale（VAS） scores,Ramsay sedation scale（RSS） scores and the incidences of adverse reactions 1,6,12 and 24 hours after operation were compared between two groups.Results The VAS scores of observation group were lower than those of control group（P〈0.05）,the VAS scores of the two groups decreased with the increasing times （P〈0.05）.There was no significant difference in the RSS scores between two groups（P〉0.05）.The incidence of complications in the observation group was lower than that in the control group（P〈0.05）.Conclusion Patient-controlled intravenous analgesia combined with ketamine might enhance the analgesic effect on STT patients as well as might not increase the incidence of complications.It is safe and reliable.

关 键 词：重症胸外伤 自控镇痛 镇痛效果 氯胺酮 

分 类 号：R614.24[医药卫生—麻醉学]