疼痛对上腹部术后呼吸肌功能不全的影响  

Effects of pain on inspiratory muscle dysfunction after upper abdominal surgery

作　　者：孙继雄[1] 郭建华[2] 石学银[3] 

机构地区：[1]上海市东方医院麻醉科,200120 [2]上海市东方医院ICU,200120 [3]第二军医大学长征医院麻醉科

出　　处：《临床麻醉学杂志》2003年第5期268-269,共2页Journal of Clinical Anesthesiology

摘　　要：目的　观察疼痛在上腹部手术后呼吸肌功能不全中所起的作用。方法　ASAⅠ～Ⅱ级择期腹腔镜胆囊切除术患者 30例 ,随机分为病人自控镇痛 (PCA)组与对照组 ,每组 15例。用最大吸气压 (MIP)和最大呼气压 (MEP)来评估呼吸肌功能。两组于术前 ,术后 2 4、4 8h分别测定MIP、MEP ,并用视觉模拟疼痛评分法 (VAS)评估疼痛程度。结果　术后对照组的MIP与MEP比术前显著下降 (P <0 0 5 )。VAS评分两组均增加 ,与术前相比 ,对照组有显著差异 (P <0 0 5 )。两组相比 ,PCA组的VAS增加明显少于对照组 (P <0 0 5 )。MIP、MEP和疼痛在统计学上有显著相关 (P <0 0 1)。结论　疼痛是导致上腹部术后呼吸肌功能不全的一个重要因素 。Objective To observe the effects of pain on inspiratory muscle dysfunction after upper abdominal surgery Methods In a randomized study, 30 patients undergoing elective laparoscopic cholecystectomy were assigned into patients controlled analgesia(PCA)group( n= 15) and controll group( n= 15) Inspiratory and expiratory muscle function was assessed through maximal inspiratory pressure(MEP) and maximal expiratory pressure (MEP), respectively Measurements were made before surgery, at 24, 48h after surgery Pain was assessed with a visual analog scale(VAS) Results Upper abdominal surgy decreased MIP and MEP in both groups MIP and MEP in controll group were statistically significantly decreased compared with those before( P< 0 05) VAS increased comparably after upper abdominal surgery in both groups, the increase of VAS was significantly less in PCA group than that in the control( P< 0 05) The change of MIP and MEP was significantly related to postoperative pain( P< 0 01) Conclusion Pain is an important factor contributing to the development of inspiratory muscle dysfunction after upper abdominal surgery, and PCA can partly reduce this dysfunction

关 键 词：疼痛 上腹部手术 呼吸肌功能不全 腹腔镜胆囊切除术 病人自控镇痛 

分 类 号：R614[医药卫生—麻醉学]