CAJ | 학술논문

目的探讨妇科腹部手术后使用静脉给药式镇痛泵(PCIA)持续时间对患者疼痛程度、胃肠道功能等方面的影响.方法选择妇科腹部手术使用静脉给药式镇痛泵者,分为使用PCIA 24,48,72h3组,各30例,比较3组停止使用镇痛泵后的疼痛情况、胃肠蠕动时间、肛门排气时间、起床时间、自行排尿时间和恶心呕吐的发生情况.结果 3组患者疼痛VAS评分各时点比较差异无统计学意义；3组患者自行排尿时间比较差异无统计学意义；24h组患者肛门排气时间、起床时间均显著早于另外2组；24 h组恶心、呕吐发生率均显著低于另外2组,差异均有统计学意义. 结论镇痛泵应用能有效缓解手术后24 h内的急性疼痛,而对急性疼痛过后(24h)由于活动引起的疼痛效果不明显,但由镇痛泵(麻醉药)引起的不良反应仍起作用,如呕吐、排气时间长、留置泵引起活动不便等.故应选择恰当的时间停止静脉镇痛泵的使用,减少并发症,有利于患者的术后康复.
목적 탐토부과복부수술후사용정맥급약식진통빙(PCIA)지속시간대환자동통정도、위장도공능등방면적영향.방법 선택부과복부수술사용정맥급약식진통빙자,분위사용PCIA 24,48,72h3조,각30례,비교3조정지사용진통빙후적동통정황、위장연동시간、항문배기시간、기상시간、자행배뇨시간화악심구토적발생정황.결과 3조환자동통VAS평분각시점비교차이무통계학의의；3조환자자행배뇨시간비교차이무통계학의의；24h조환자항문배기시간、기상시간균현저조우령외2조；24 h조악심、구토발생솔균현저저우령외2조,차이균유통계학의의. 결론 진통빙응용능유효완해수술후24 h내적급성동통,이대급성동통과후(24h)유우활동인기적동통효과불명현,단유진통빙(마취약)인기적불량반응잉기작용,여구토、배기시간장、류치빙인기활동불편등.고응선택흡당적시간정지정맥진통빙적사용,감소병발증,유리우환자적술후강복.
Objective To evaluate the influence of the duration of patient-controlled intravenous analgesia (PCIA)on pain and gastrointestinal function after gynecological abdominal surgery.Methods Patients who received gynecological abdominal surgery were divided into 3 groups according to using time of PCIA for 24 hours,48 hours,72 hours.There were 30 cases in each group.Pain intensity,gastrointestinal peristalsis time,anal exhaust time,getting out-of-bed time,voluntary micturition time,nausea and vomiting were compared among three groups after stopping PCIA.Results There were no significant differences in VAS score among three groups at each time point.There were no significant differences in voluntary micturition time among three groups.The anal exhaust time,getting out-of-bed time in 24-hour group were earlier than those of the other two groups,the differences were significant; The nausea and vomiting in 24-hour group were lower than the other two groups,the difference was significant.Conclusions The application of PCIA can effectively relieve acute pain 24 hours after surgery,but the effect was not obvious on pain induced by activities after 24 hours.But the side effects induced by analgesia pump(anesthetic)still work,such as vomiting,long duration of discharge,activity inconvenience.So PCIA should be stopped at right time in order to reduce complications and facilitate for recovery of patients after the surgery.