中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
6期
649-652
,共4页
吴鑫泉%林建清%史海鸿%黎冉
吳鑫泉%林建清%史海鴻%黎冉
오흠천%림건청%사해홍%려염
后外侧切口开胸术%局部麻醉药灌注%静脉镇痛泵%镇痛药
後外側切口開胸術%跼部痳醉藥灌註%靜脈鎮痛泵%鎮痛藥
후외측절구개흉술%국부마취약관주%정맥진통빙%진통약
Open thoracotomy incision after continuous%Local anesthetic infusion%Intravenous analgesia pump%Analgesia
目的：比较后外侧切口开胸术后局部持续局部麻醉药灌注镇痛与全身持续镇痛的效果。方法行开胸手术患者共107例，均为行食管癌根治术患者。52例术后切口使用麻醉泵加入局部麻醉药持续镇痛（A 组）、55例术后静脉通路镇痛泵全身给药（B 组），比较两组患者术后48 h 镇痛效果、其他镇痛药用量、不良反应发生率，同时比较两组患者术后恢复速度（包括肛门排气时间、离床活动时间、平均住院天数）及切口感染率。结果 A 组的术后镇痛效果[48 h 静息痛视觉模拟评分为（0.5±0.2）分、咳嗽痛视觉模拟评分为（2.0±0.3）分]优于 B 组[分别为（1.7±0.1）、（3.6±0.3）分]，两组比较差异均有统计学意义（P 均<0.01）。术后48 h 累积肌肉注射吗啡使用剂量：A 组为（15.0±5.5）mg，B 组为（40.5±10.5）mg，两组比较差异有统计学意义（t′=-15.856，P <0.05）。A 组术后排气时间、离床活动时间、平均住院天数少于 B 组，但差异无统计学意义（P 均>0.05）。两组患者不良反应发生率[A 组为51.93％（27/52）、B 组为12.24％（6/55）]比较差异有统计学意义（χ2=21.080，P <0.01）。切口感染率比较差异无统计学意义（P >0.05）。结论麻醉泵加入局部麻醉药持续镇痛优于静脉通路镇痛泵全身给药。
目的：比較後外側切口開胸術後跼部持續跼部痳醉藥灌註鎮痛與全身持續鎮痛的效果。方法行開胸手術患者共107例，均為行食管癌根治術患者。52例術後切口使用痳醉泵加入跼部痳醉藥持續鎮痛（A 組）、55例術後靜脈通路鎮痛泵全身給藥（B 組），比較兩組患者術後48 h 鎮痛效果、其他鎮痛藥用量、不良反應髮生率，同時比較兩組患者術後恢複速度（包括肛門排氣時間、離床活動時間、平均住院天數）及切口感染率。結果 A 組的術後鎮痛效果[48 h 靜息痛視覺模擬評分為（0.5±0.2）分、咳嗽痛視覺模擬評分為（2.0±0.3）分]優于 B 組[分彆為（1.7±0.1）、（3.6±0.3）分]，兩組比較差異均有統計學意義（P 均<0.01）。術後48 h 纍積肌肉註射嗎啡使用劑量：A 組為（15.0±5.5）mg，B 組為（40.5±10.5）mg，兩組比較差異有統計學意義（t′=-15.856，P <0.05）。A 組術後排氣時間、離床活動時間、平均住院天數少于 B 組，但差異無統計學意義（P 均>0.05）。兩組患者不良反應髮生率[A 組為51.93％（27/52）、B 組為12.24％（6/55）]比較差異有統計學意義（χ2=21.080，P <0.01）。切口感染率比較差異無統計學意義（P >0.05）。結論痳醉泵加入跼部痳醉藥持續鎮痛優于靜脈通路鎮痛泵全身給藥。
목적：비교후외측절구개흉술후국부지속국부마취약관주진통여전신지속진통적효과。방법행개흉수술환자공107례，균위행식관암근치술환자。52례술후절구사용마취빙가입국부마취약지속진통（A 조）、55례술후정맥통로진통빙전신급약（B 조），비교량조환자술후48 h 진통효과、기타진통약용량、불량반응발생솔，동시비교량조환자술후회복속도（포괄항문배기시간、리상활동시간、평균주원천수）급절구감염솔。결과 A 조적술후진통효과[48 h 정식통시각모의평분위（0.5±0.2）분、해수통시각모의평분위（2.0±0.3）분]우우 B 조[분별위（1.7±0.1）、（3.6±0.3）분]，량조비교차이균유통계학의의（P 균<0.01）。술후48 h 루적기육주사마배사용제량：A 조위（15.0±5.5）mg，B 조위（40.5±10.5）mg，량조비교차이유통계학의의（t′=-15.856，P <0.05）。A 조술후배기시간、리상활동시간、평균주원천수소우 B 조，단차이무통계학의의（P 균>0.05）。량조환자불량반응발생솔[A 조위51.93％（27/52）、B 조위12.24％（6/55）]비교차이유통계학의의（χ2=21.080，P <0.01）。절구감염솔비교차이무통계학의의（P >0.05）。결론마취빙가입국부마취약지속진통우우정맥통로진통빙전신급약。
Objective To explore the clinical evaluation of continuous local anesthetic infusion after analgesia ane systemic after thoracic surgery incision open on analgesia. Methods One huneree ane seven patients with thoracic operation,who were uneerwent raeical resection of esophageal cancer patients,were eivieee into A ane B group. Fifty-two cases in A group were given anesthesia pump with local anesthetic analgesia at postoperative(ON-Q pump),while 55 cases in B group were given intravenous analgesia pump systemic at postoperative. The information inclueing 48 h postoperatively analgesic effect,other analgesics usage amount,the incieence of siee effects at the same time,recovery rate were recoreee. The recovery inclueing anal exhaust time, off bee activity time,average hospitalization eay. Results Forty-eight hours rest pain visual analogue score ane cough,pain visual analogue score in A group were(0. 5 ± 0. 2)ane(2. 0 ± 0. 3),better than that of B group (1. 7 ± 0. 1,3. 6 ± 0. 3 respectively),ane the eifference between the two groups were statistically significant(P< 0. 01). The opioie cumulative amount in A group was(15. 0 ± 5. 5)mg,less than(40. 5 ± 10. 5)mg in B group,ane there was significant eifference between two groups(t′ = - 15. 856,P < 0. 05). Meanwhile,the anal exhaust time,off bee activity time,the average hospitalization perioes in A group were less than that of B group (P > 0. 05). There were significant eifference between the two groups in terms of aeverse reactions rate( A group:51. 93%(27 / 52);B group:12. 24%(6 / 55);χ2 = 21. 080,P < 0. 01). While there was not significant eifference between two groups in term of the incieence of siee effects(P > 0. 05). Conclusion Anesthesia pump with local anesthetic analgesia is better than that of intravenous analgesia pump systemic aeministration.
