多发性乳腺结节微波消融术中的疼痛管理  

Pain Management During Microwave Ablation of Multiple Breast Nodules

作　　者：王诗诗 王璐 李娟[2] 庄敏 李佳密 卢漫[2] Wang Shishi;Wang Lu;Li Juan;Zhuang Min;Li Jiami;Lu Man(School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China;Ultrasound Medical Center,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 61004l,China)

机构地区：[1]成都中医药大学医学与生命科学学院,成都市610072 [2]四川省肿瘤临床医学研究中心,四川省肿瘤医院,四川省肿瘤研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院超声医学中心,成都市610041

出　　处：《中国超声医学杂志》2023年第11期1235-1238,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨不同镇痛方式在乳腺多发良性结节微波消融(MWA)治疗的效果。方法选取MWA治疗乳腺多发良性结节的92例患者,按镇痛方式分为3组:局部麻醉组(L组,n=31)、局部麻醉+乳腺后间隙麻醉组(R组,n=31)、局部麻醉+乳腺后间隙麻醉+胸神经阻滞组(P组,n=30)。采用数字评定量表(NRS)记录术中及术后2、6、12、24、48 h的疼痛程度。记录术后镇痛需求及并发症情况。结果R组、P组在术中及术后2、6 h的NRS评分均低于L组(P<0.05),而R组、P组差异无统计学意义(P>0.05)。P组在术后12、24、48 h的NRS评分均低于L组、R组(P<0.05),而L组、R组差异无统计学意义(P>0.05)。R组、P组术后镇痛需求低于L组,差异有统计学意义(P<0.05)。术后无严重并发症。结论局部麻醉联合乳腺后间隙麻醉及胸神经阻滞能有效降低MWA治疗乳腺多发良性结节的疼痛,减少术后镇痛需求。Objective To investigate the efficacy of different analgesic methods in microwave ablation(MWA)of multiple benign breast nodules.Methods 92 patients with multiple benign breast nodules treated by MWA were selected and divided into three groups according to the anesthesia method:local anesthesia group(group L,n=31),local anesthesia+retromammary space anesthesia group(group R,n=31),local anesthesia+retromammary space anesthesia+pectoral nerve block group(group P,n=30).Numerical rating scale(NRS)was used to record the pain levels during and 2,6,12,24 and 48 hours after ablation.Postoperative analgesic demands and complications were recorded.Results The NRS scores of group R and group P were significantly lower than those of group L during and 2 and 6 hours after operation(P<0.05),but there was no significant difference between group R and group P(P>0.05).The NRS scores of group P at 12,24 and 48 hours after operation were significantly lower than those of group L and group R(P<0.05),but there was no significant difference between group L and group R(P>0.05).The postoperative analgesic demands of group R and group P were lower than that of group L,and the difference was statistically significant(P<o.05).There were no severe complications occurred after ablation.Conclusions Local anesthesia combined with retromammary space anesthesia and pectoral nerve block can effectively reduce the pain of MWA treatment for MBBN and reduce the demand for postoperative analgesia.

关 键 词：神经阻滞 微波消融 乳腺疾病 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]