两种镇痛方式对开胸术后患者舒适度及镇痛效果的分析  

Analysis of two analgesia methods on the comfort degrees and the analgesic efficacy for elderly patients after thoracic surgery

作　　者：李洁[1] 王贵桃[1] 胡素清[1] 刘素芝[1] 丁颖[1] 

机构地区：[1]内蒙古医科大学附属医院胸外科,内蒙古呼和浩特010059

出　　处：《实用临床医药杂志》2016年第14期66-68,75,共4页Journal of Clinical Medicine in Practice

摘　　要：目的对比分析静脉自控镇痛方式(PCIA)和硬膜外自控镇痛方式(PCEA)对胸外科开胸术后患者舒适度及镇痛效果的影响。方法选择胸外科行择期手术60例患者,根据患者术后采用镇痛方式的不同,随机分为PCIA组和PCEA组,各30例。观察比较患者术后24h、48h的舒适度和疼痛强度。结果从舒适状况各维度分析,24h时PCEA组生理维度评分(9.90±1.86)高于PCIA组(8.67±2.15)(P<0.05),PCEA组社会文化维度评分(16.33±2.54)高于PCIA组(13.27±3.05)(P<0.05);48h时PCEA组生理维度评分(10.23±1.85)高于PCIA组(9.00±2.45)(P<0.05),PCEA组社会文化维度评分(16.87±1.70)高于PCIA组(13.67±2.75)(P<0.05),而24h、48h时在心理、环境维度差异无统计学意义(P>0.05)。从疼痛强度分析,24h时PCEA组疼痛强度评分(6.43±1.34)低于PCIA组(7.50±1.33)(P<0.05);48h时PCEA组疼痛强度评分(6.43±1.14)低于PCIA组(7.45±1.33)(P<0.05)。结论与PCIA组相比,PCEA组能从生理、社会文化维度上获得更高的舒适度,镇痛效果较好,可作为胸外科患者术后首选的镇痛方式。Objective To analyze the effect of controlled intravenous analgesia （PCIA） and controlled epidural analgesia （PCEA） on comfort degrees and the analgesic efficacy of elderly patients after the thoracic surgery. Methods Sixty patients with selective operation in the thoracic surgery were randomly divided into PCIA group and PCEA group according to the different analgesia after sur- gery, with 30 patients in each group. Comfort degrees and pain intensity after 24 h and 48 h of opera- tion were analyzed. Results Physiological dimension score at 24 h in PCEA group was （9.90 ± 1.86） points, which was higher than （8.67 ± 2.15 ） in PCIA group （P 〈 0.05 ）, and social and cul- tural dimension score in PCEA group was （16.33 ±2.54） points, which was higher than （13.27 ± 3.05 ） points in PCIA group （P 〈 0.05 ）. Physiological dimension score at 48 h in PCEA group was （ 10.23 ± 1.85） points, which was higher than （9.00 ± 2.45） points in PCIA group （P 〈 0.05 ）, and social and cultural dimension in PCEA group was （ 16.87 ± 1.70） points, which was higher than （13.67 ± 2.75 ） points in PCIA group （P 〈 0.05 ）, but there was no significant difference in psycho- logical and environmental dimension score at 24 h and 48 h in two groups （P 〉 0.05 ）. Pain intensity scores at 24 h in PCEA group was （6.43 ± 1.34） points, which was higher than （7.50 ± 1.33 ） points in PCIA group （P 〈 0.05 ）, and it was （6.43 ± 1.14） points in PCEA group at 48 h, which was higher than （7.45 ± 1.33 ） points in PCIA group （ P 〈 0.05 ）. Conclusion Compared with PCIA group, higher comfort degrees and better analgesic effect in physiological and social and cultural dimension are found in PCEA group, which can be used as the first choice of analgesia for the elderly patients in the thoracic surgery.

关 键 词：静脉自控镇痛 硬膜外自控镇痛 镇痛效果 舒适度 

分 类 号：R473.6[医药卫生—护理学]