肋间神经精准冷冻对单操作孔胸腔镜气胸手术后镇痛效应的影响  

THE ANALGESIC EFFICACY OF PRECISION INTERCOSTAL NERVE CRYOANALGESIA IN SINGLE-PORT THORACOSCOPIC OPERATION FOR PRIMARY SPONTANEOUS PNEUMOTHORAX

作　　者：褚剑[1] 马永富[1] 刘阳[1] 李敏[1] 李捷[1] 张涛[1] 郭俊唐[1] 梁朝阳[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《中国疼痛医学杂志》2015年第7期517-520,共4页Chinese Journal of Pain Medicine

基　　金：北京市科学技术委员会首都市民健康项目培育(Z111100074911004)

摘　　要：目的:观察肋间神经精准冷冻止痛术用于单操作孔胸腔镜气胸手术后患者镇痛的临床效果。方法:2011年1月至2013年4月期间,于解放军总医院胸外科接受单操作孔胸腔镜气胸手术患者60名,随机分为2组,每组30例:肋间神经冷冻组(A组),术中施行精准解剖肋间神经分支冷冻止痛术。对照组施行术后自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)(C组)。术后观察记录视觉模拟疼痛评分(visual analogus scale,VAS)及术后肺部并发症的发生情况。结果:术后第1、3、5、7天,A组术后疼痛评分均明显低于C组(P<0.01)。术后A组、C组肺部并发症发生率都较低,两组对比无统计学意义。结论:肋间神经精准冷冻止痛能有效缓解患者术后疼痛,并且术后并发症的发生率较低,是一种安全有效的止痛方法。Objective： To evaluate the clinical efficacy of intercostal nerve cryoanalgesia in single-port thoracoscopic operation for primary spontaneous pneumothorax based on the accurate anatomy. Methods： Sixty patients（18~44 years） were randomly assigned into 2 groups（n =30 each） ： intercostal nerve cryoanalgesia（group A） and patient-controlled intravenous analgesia（PCIA）（group C）. The pain intensity measured by visual analogue scale was calculated at the time of pretreatment, and at day 1, 3, 5, 7 after treatment. Results： The pain intensity measured by visual analogue scale was significantly reduced in the cryoanalgesia group compared with the control group（P〈 0.01）. Conclusion： This study demonstrates that freezing of the intercostal nerve at-70℃ for 90 seconds was a safe and long-term effective approach for relieving post-thoracotomy pain.

关 键 词：肋间神经 精细解剖 冷冻止痛 单孔胸腔镜手术 自发性气胸 

分 类 号：R655[医药卫生—外科学]