自控静脉镇痛联合预自控强化模式在肺癌术后疼痛治疗的应用  

The Application of Regular Analgesia Combined with Pre-controlled Enhancement Mode in Postoperative Pain Treatment of Lung Cancer

作　　者：蒋艳华[1] 杨青[1] 周和玲 罗珊[1] 陈艳丽[1] 吴传美 JIANG Yanhua;YANG Qing;ZHOU Heling;LUO Shan;CHEN Yanli;WU Chuanmei(Sichuan Cancer Hospital,Chengdu Sichuan 610041)

机构地区：[1]四川省肿瘤医院,四川成都610041

出　　处：《智慧健康》2023年第30期27-30,共4页Smart Healthcare

摘　　要：目的探讨自控静脉镇痛联合预自控强化模式在加速康复理念下肺癌患者术后咳嗽和下床活动疼痛管理中的应用价值。方法选取本病区2020年7—12月收治的218例单孔胸腔镜下肺叶切除手术后采用自控静脉镇痛(PCIA)进行疼痛治疗的肺癌患者,随机分为对照组和观察组,对照组(110例)采用常规镇痛泵干预,观察组(108例)采用PCIA规律镇痛联合预自控镇痛泵干预,比较两组患者术后咳嗽和下床活动时疼痛情况、下床活动情况以及术后并发症发生情况。结果和对照组相比,观察组患者在术后当日及接下来3d内疼痛评分都明显偏低(P<0.05);两组患者首次下床活动距术后时间、手术当日下床活动距离比较,差异无统计学意义(P>0.05),观察组患者术后1d、2d、3d下床活动的活动距离均长于对照组(P<0.05);观察组患者并发症总发生率低于对照组(P<0.05)。结论肺癌患者通过PCIA规律镇痛联合预自控追加剂量强化模式进行术后疼痛治疗,能够降低咳嗽引起的疼痛和下床活动引起的疼痛,增加下床活动的时间和步行距离,降低并发症发生率,对促进患者术后康复具有重要意义。Objective To explore the application value of regular analgesia combined with preself-control enhancement mode in the postoperative pain management of cough and getting out of bed in patients with lung cancer under the concept of accelerated rehabilitation.Methods A total of 218 patients with lung cancer who underwent patient controlled intravenous analgesia(PCIA)for pain treatment after single-port thoracoscopic lobectomy from July to December 2020 were selected and randomly divided into control group and observation group.A total of 110 patients in the control group received PCIA regular analgesia combined with self-controlled intensive mode of pain intervention when pain worsened,and 108 patients in the observation group received PCIA regular analgesia combined with pre-controlled intensive mode of pain intervention.Postoperative cough and getting out of bed pain,getting out of bed activity,and postoperative complications of the two groups were compared.Results Compared with the control group,the pain scores in the observation group were significantly lower on the day after surgery and in the following three days(P<0.05);There was no statistical significance between the first time of getting out of bed and the postoperative time and the postoperative day of getting out of bed between the two groups(P>0.05).The distance of getting out of bed on 1,2 and 3 days after surgery in the observation group was longer than that in the control group(P<0.05).The incidence of complications in the observation group was 16.67%,lower than that in the control group(P<0.05).Conclusion PCIA regular analgesia combined with pre-control additional dose intensification mode for postoperative pain treatment of lung cancer patients can reduce the pain caused by cough and the pain caused by getting out of bed,increase the time and walking distance of getting out of bed,and reduce the incidence of complications,which is of great significance for promoting postoperative rehabilitation of patients.

关 键 词：自控静脉镇痛 预镇痛 肺癌 胸腔镜手术 疼痛 

分 类 号：R734.2[医药卫生—肿瘤] R614[医药卫生—临床医学]