改良肋间神经保护联合静脉自控镇痛多模式防治开胸术后疼痛的应用被引量：3

Clinical study of multi model analgesia of intercostal nerve protection combined with patientcontrolled intravenous analgesia after thoracotomy

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摘要目的探讨改良肋间神经保护联合静脉自控镇痛多模式防治开胸术后疼痛的临床效果。方法选择2014年7月至2016年6月施行开胸手术的患者80例，随机分为观察组和对照组，每组40例，观察组采用改良的肋间神经保护技术联合静脉自控镇痛防治开胸术后疼痛；对照组采用传统手术操作方法及静脉自控镇痛进行治疗。观察患者术后疼痛VAS评分、镇痛不良反应和肺部并发症的发生率及平均住院时间。结果观察组术后各时点VAS评分与对照组比较，差异有统计学意义（P〈0．05）；观察组术后60d时无痛患者发生率、镇痛不良反应发生率、肺部并发症发生率及平均住院时间分别为60．00％、0、5．00％、（16.60±2．50）d，与对照组的22．50％、15．00％、20．00％、（19．80±3．00）d相比，差异有统计学意义（P〈0．05）。结论改良肋间神经保护联合静脉自控镇痛多模式防治开胸术后疼痛的效果明显，不良反应少，并发症少，操作简单、安全，是一种较理想的镇痛模式。 Objective To investigate the clinical effect of multi model analgesia of intercostal nerve protection combined with patient-controlled intravenous analgesia after thoracotomy. Methods In 2014 July to 2016 June 80 cases of patients with thoracic operation, were randomly divided into observation group and control group, 40 cases in each group, the observation group using improved surgical operation method combined with patient-controlled intravenous analgesia after thoraeotomy pain treatment, the control group using the traditional methods of operation and patient-controlled intravenous analgesia for treatment. The postoperative pain VAS, the incidence of painless patients of postoperative 60 d, analgesia adverse reactions , the incidence of pulmonary complications and average hospitalization time. Results The scores of every time point analgesia patients in the observation group （VAS score） compared with the control group, the difference was statistically significant （P〈0.05）. the incidence of painless patients of postoperative 60 d, the incidence of analgesia adverse reactions, incidence of pulmonary complications, and the average hospitalization time of observation group were 60.00%, 0, 5.00%, （16.60 ± 2.50） d, and the control group were 22.5%, 15.00%, 20.00%, （19.80 ±3.00） d, compared statistically significant difference （P〈0.05）. Conclusions Effect of multi model analgesia of intercostal nerve protection combined with patientcontrolled intravenous analgesia after thoracotomy is significantly, less adverse reaction, less complications, simple operation, safety, and is an ideal mode of analgesia.

作者蒋毅王君陶宏赵宏赵恒贻赵守华秦存伟张显平王青李蕴

机构地区山东省济宁医学院附属滕州市中心人民医院心胸外科山东省济宁医学院附属滕州市中心人民医院麻醉科山东省济宁医学院附属滕州市中心人民医院手术室

出处《中国临床实用医学》 2016年第5期34-37,共4页 China Clinical Practical Medicine

基金济宁医学院2015年度校级科研计划项目（JY2015KJ030）

关键词开胸术肋间神经保护静脉自控镇痛多模式镇痛 Thoracotomy The protection technology of modified intercostal nerve Patient controlled intravenous analgesia Muhimodal analgesia

分类号 R65 [医药卫生—外科学] R61 [医药卫生—外科学]