CAJ | 학술논문

目的：评价食管癌术后应用肋间神经冷冻镇痛的临床效果。方法：选取2010年2月-2012年6月本科收治的157例食管癌患者，按照随机数字表法将其分为三组，肋间神经冷冻组（n=65）：采用术中冷冻肋间神经止痛，每根肋间神经冷冻温度为-57℃左右，冷冻时间为90 s；镇痛泵组（n=51）：术后由麻醉师给予静脉用镇痛泵（舒芬太尼）止痛；对照组（n=41）：临时肌注吗啡。通过视觉模拟疼痛评分法评价术后疼痛程度，比较各组肺部并发症发生率及第1秒用力呼气容积（FEV1）实测值，同时比较各组胃肠道功能恢复时间。结果：肋间神经冷冻组的术后镇痛效果、肺部并发症、胃肠道排气排便情况等方面均明显优于镇痛泵组和对照组，差异均有统计学意义（P<0.05）。结论：肋间神经冷冻术可明显减轻食管癌患者开胸术后疼痛，且能降低并发症发生率，可作为常规选择替代人工镇痛泵。
목적：평개식관암술후응용륵간신경냉동진통적림상효과。방법：선취2010년2월-2012년6월본과수치적157례식관암환자，안조수궤수자표법장기분위삼조，륵간신경냉동조（n=65）：채용술중냉동륵간신경지통，매근륵간신경냉동온도위-57℃좌우，냉동시간위90 s；진통빙조（n=51）：술후유마취사급여정맥용진통빙（서분태니）지통；대조조（n=41）：림시기주마배。통과시각모의동통평분법평개술후동통정도，비교각조폐부병발증발생솔급제1초용력호기용적（FEV1）실측치，동시비교각조위장도공능회복시간。결과：륵간신경냉동조적술후진통효과、폐부병발증、위장도배기배편정황등방면균명현우우진통빙조화대조조，차이균유통계학의의（P<0.05）。결론：륵간신경냉동술가명현감경식관암환자개흉술후동통，차능강저병발증발생솔，가작위상규선택체대인공진통빙。
Objective:To evaluate the clinical effect of intercostals nerve freezing analgesia after esophagectomy for patients.Method:157 patients with esophageal carcinoma were selected in our department from February 2010 to June 2012,they were were randomly divided into three groups.Intercostal nerve cryoanalgesia group(n=65):it was treated with freezing intercostal nerve pain in surgery,each root intercostals nerve freezing temperature was about -57 ℃,the freezing time was 90 s.Analgesia pump group(n=51):it was treated with intravenous analgesia pump (sufentanil)to stop the pain by anesthesiologist after the surgery.The control group (n=41):intramuscular injection of morphine.The degree of postoperative pain was evaluated through visual analog pain score method,pulmonary complications and forced expiratory volume in 1 second (FEV1) measured values were compared in three groups,and the gastrointestinal function recovery time were compared.Result:Postoperative analgesia effect,pulmonary complications,pulmonary function, gastrointestinal exhaust and defecation situation in the intercostal nerve cryoanalgesia group were superior to analgesia pump group and the control group,the differences were statistically significant(P<0.05).Conclusion:Freezing intercostal nerves can obviously reduce open thoracic esophageal cancer patients postoperative pain,and can reduce the incidence of complications,can be used as a routine alternative artificial analgesia pump.