老年患者术后硬膜外自控镇痛的安全性与有效性研究  

The Aged Patients' Security And Effect of PCEA Post Operation

作　　者：赵存凤[1] 赵继军[1] 姚梅芳[1] 庹焱[2] 

机构地区：[1]第二军医大学长海医院护理部,200433 [2]第二军医大学护理教研室,200433

出　　处：《现代护理》2002年第12期903-907,共5页Modern Nursing

基　　金：全军医药卫生科研基金 (0 1L0 55)资助项目

摘　　要：目的　评价硬膜外自控镇痛 (PCEA)用于老年病人术后镇痛的有效性、安全性 ,以指导临床镇痛方案的实施及观察要点。方法　 90例ASAⅠ～Ⅱ级 ,腹部术后行PCEA病人分为青年组 [Q组 ,(42 .5± 5 .6 )岁 ,芬太尼 2 μg/ml+0 .1%布比卡因 +氟哌利多 2 0 μg/L]。老年组 (6 9.1± 2 .3)岁 ,随机分为F组 (芬太尼 1μg/ml+0 .1%布比卡因 +氟哌利多 2 0 μg/ml) ,T组 (曲马多 1mg/ml+组F药物 ) ,对比观察其镇痛效果及副作用。结果　 3组病人镇痛效果较好 (优良率Q组 87% ,F组 93% ,T组 97% ) ,呼吸、循环基本稳定 ,老年嗜睡及出汗发生率较高 (F组为 16 %及 10 % ,T组为 10 %及 2 6 % ) ,但统计学处理 3组比较P >0 .0 5 ,差异无显著性。结论　老年人芬太尼和布比卡因或联合曲马多行PCEA ,镇痛效果均良好 ,但应加强呼吸。Objective Purpose Evaluating the analgesic security and effect of PCEA applied to aged patients post operation, which directed the enforcement of the clinic analgesic method and observation main points. Methods 90 patients of ASA Ⅰ-Ⅱ grade belly operation having taken PCEA were divided into young group [Q group, (42.5+5.6) years old, fentanyl 2mg/ml+0.1% bupivacaint+droperidol 20mg/L], aged group, (69+2.3 years old), was divided into F group (fentanyl 1 mg/ml+0.1% bupivacain+-20 mg/ml), T group (tramadol hydrochloribe 1mg/ml+drugs of F group) and observed. Results The three groups patients' analgesic effect was good. (The superior rate were 87% in Q group, 93% in F group, 97% in T group), respiration and circulation were stable basically. The aged lethargy and perspiration rate were high. (16% and 10% in F group, 10% and 26% in T group). But statistics handling compared among 3 groups, P > 0.05, there were not obvious different. Conclusions Fentanyl added bupivacain or associated with tramadol hydrochloribe was used to aged people's PCEA and got food analgesic effect, but breath, circulation and noetic function should be strengthened to monitor.

关 键 词：术后 硬膜外自控镇痛 安全性 有效性 研究 老年人 

分 类 号：R473.6[医药卫生—护理学]