胸科手术后病人自控镇痛的应用  

Application of PCA in thoracic surgery

作　　者：袁银英[1] 陈国强[1] 

机构地区：[1]广东揭阳市人民医院麻醉科,522000

出　　处：《中国基层医药》2004年第4期433-434,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　评价胸科手术后病人自控镇痛与传统的肌内注射哌替啶镇痛的临床效果。方法　 110 8例在全麻下行贲门癌或食管癌根治术的病人 ,随机分为肌注哌替啶组 (A组 )和病人自控镇痛PCA组 (B组 )。A组病人术后感觉疼痛时肌注哌替啶镇痛 ;B组携带镇痛泵 ,由病人或家属自控镇痛。术后 1、8、2 4、72h进行随访并记录镇痛评分 (VAS)等 ,术后 1周随访肺部并发症情况。结果　术后B组疼痛评分明显低于A组 (P<0 0 5或P <0 0 1)。术后 1周肺部并发症A组为 14例 ,而B组仅 2例 (P <0 0 1)。结论　PCA镇痛效果明显 ,肺部并发症发生率低 ,优于传统的哌替啶肌注。Objective The aim of this study is to compare clinical effect of PCA and traditional muscular injection of dolentin after thoracic surgery.Methods 1108 cases of patients of gastric cardiac carcinoma or esophageal carcinoma underwent radical operation under general anesthesia were rnadomly divided into muscular injection of dolentin group(A) and patient self-control PCA group(B).The patients of group A were also given intramuscular injection of dolentin when pain was felt.The patients of group B were given with pain relief pumps controlled by the patients them selves and their families.Pain was scored 1,8,24 and 72 hours after operation.And one week follow-up was conducted for observing complicatons.Results Pain relief score was significantly lower in group B than in group A after operation(P<0.05 or P<0.01).Lung complication in group A one week after operation accounted for 14 cases.While only two cases was fond in group B(P<0.01).Conclusion The total effective rate of pain relief group B reached 94%.Complications of lung was also low in group B.PCA is better than traditional intramuscular injection of dolentin.

关 键 词：胸外科 术后镇痛 病人自控镇痛 哌替啶 镇痛泵 肌肉注射 疼痛 

分 类 号：R614[医药卫生—麻醉学]