摘要
目的比较腹部术后患者自控镇痛与传统的肌肉注射杜冷丁镇痛的临床效果。方法42例患者在全麻下行胃癌根治、脾切除、结肠手术、胆囊切除及胆肠吻合术，术前检查肺功能均正常。随机将患者分成自控镇痛（patient controlled analysia，PCA）组和肌注杜冷丁（B）组。PCA组由电子PCA镇痛泵行自动皮下给药镇痛、B组患者术后感觉疼痛时，肌注杜冷丁镇痛。术后回病房分别于即刻，2，4，8，12，24，48h观察并记录2组的镇痛评分（VAS）、血压、心率、呼吸频率及不良反应等。术后一周观察肺部并发症情况。结果术后0～48h比较2组患者血压、心率、呼吸差异无显著性，PCA组疼痛评分明显小于B组，P〈0．05或P〈0．01。术后7d肺部并发症B组为4例，而PCA组仅1例，P〈0．01。结论皮下PCA用于肺功能正常的腹部手术患者术后镇痛对血压、心率和呼吸无影响，镇痛效果明显，肺部并发症发生率低，优于传统的肌注杜冷丁组，是一种用于腹部手术后镇痛较为理想的方法。
Objective To study the clinical effects of using the portable patient - controlled analgesic pump for patients with abdominal operation. Methods Divided 42 patients with abdominal operation into PCA group and B group randomly, there were 21 cases in the each group. The patient - controlled analgesic pump was used in the PCA group to ameliorate the postoperative pain, the dolantin was used in the B group. Compared the effects of the analgesia in the 2 groups. Results There were no significant differences between the 2 group in the blood pressure, heart rate and the respiratory frequence, P〈 0.05. The incidence rate of postoperative complication in the PCA group was significant lower than that of in the B group. The analgesic condition in the PCA group was better than that of in the B group, too. Conclusion Using the portable patient - controlled analgesic pump for patients with abdominal operation is an effective and safety method to ameliorate the postoperative pain.
基金
2004年汕头市科技局立项项目{汕府科[2004]102号}
关键词
自控镇痛泵
疗效
护理
Patient-controlled pump
Effects
Nursing
