硬膜外自控镇痛在子宫动脉栓塞术治疗子宫腺肌病中的应用  

Application of patient-controlled epidural analgesia in the uterine arterial embolization for adenomyosis

作　　者：刘萍[1] 陈春林[1] 佘守章[1] 雷蔚华[1] 谢小青[1] 

机构地区：[1]广州市第一人民医院,510180

出　　处：《中国实用妇科与产科杂志》2002年第11期675-676,共2页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：20 0 0年广东省科委重点科技项目资助 (2 0 12KM 0 44 0 4S)

摘　　要：目的　探讨病人硬膜外自控镇痛 (patientcontrolledepiduralanalgesia ,PCEA)在子宫动脉栓塞术 (uter inearterialembolization ,UAE)治疗子宫腺肌病中的应用。方法　选择 75例行UAE治疗子宫腺肌病的患者 ,随机分成 3组 ,Ⅰ、Ⅱ组术前开始予自控镇痛 2 4小时 ,予相同的镇痛模式 ,两种不同的药物配伍 :罗哌卡因配伍吗啡为Ⅰ组 (n =30 ) ,罗哌卡因、吗啡配伍氟哌啶为Ⅱ组 (n =30 ) ,Ⅲ组术后自觉疼痛时予传统的肌注四氢巴马汀(颅痛定 )或盐酸哌替啶 (n =15 ) ,比较三组术中和术后 2 4小时内的镇痛效果、不良反应及安全性。结果　PCEAⅠ组、Ⅱ组的镇痛效果明显优于Ⅲ组 ,结合不良反应其临床疗效为 :Ⅱ组 >Ⅰ组 >Ⅲ组。结论　UAE治疗子宫腺肌病术中应用PCEA镇痛效果好 ,不良反应小 ,舒适、安全。Objective\ To study the effectiveness and safety of patient epidural controlled analgesia (PCEA) for post-operative pain relief after uterine arterial embolization(UAE) for adenomyosis.Methods\ 75 adult patients (ASA grade ) undergoing transcatheter adenomyosis, were randomly divided into three groups: the PCEA Ⅰ Group ( n=30)?PCEA ⅡGroup(n=30) and the Ⅲ Group ( n=15) who were performed intramuscular injection (plus analgesic of Rotundin or Pethidine Hydrochloride)when the pain onset after operation. Group Ⅰ was perfomed PCEA 24 hours prior the operntion by ropivacaine+morphine,Group Ⅱ was perfomed by ropivacaine+morphine+droperidol in the same model as that in Group Ⅰ. Results\ Pain relief in two PCEA groups (Ⅰ ?Ⅱ)were obviously superior to that of the Ⅲ Group (P<0.01). The incidence of side effects (nausea, vomiting) of Group Ⅱ was the least.Conclusion\ During or after UEA, PCEA can effectively relieve pain with less side effects and high safety.

关 键 词：硬膜外自控镇痛 子宫动脉栓塞术 治疗 子宫腺肌病 应用 

分 类 号：R711.74[医药卫生—妇产科学]