国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
16期
1962-1964
,共3页
肋间神经冷冻%硬膜外%术后镇痛%开胸术
肋間神經冷凍%硬膜外%術後鎮痛%開胸術
륵간신경냉동%경막외%술후진통%개흉술
Intercostal nerve freezing%Epidural%Postoperative analgesia%Thoracotomy
目的 探讨改良肋间神经冷冻技术在促进传统开胸手术后恢复中的应用价值及优势.方法 将100例择期传统切口开胸的病人随机分为A组和B组;A组为改良肋间神经冷冻组(n=50),使用北京K001AND公司JT-Ⅰ型冷冻治疗仪在关胸前对切口所在肋间及上、下各一个肋间和留置胸腔引流管所在肋间的肋间神经进行冷冻;B组为连续硬膜外自控镇痛组(n=50),采用日本wells公司的电子泵,用吗啡加氟哌利多行连续硬膜外自控镇痛(patient control epidural analgesia,PCEA).二组病人均采用视觉模拟评分法(visual analogue scale,VAS)评定术后疼痛程度,观察二组病人手术后2h、4h、12h、24 h、48h时的VAS的评分,恶心、呕吐、呼吸抑制,搔痒、肠麻痹等发生率.结果 A组手术后止痛效果好于B组,手术后镇痛副反应[如恶心(10.3%vs 23.3%)、呕吐(10.0%vs 26.7%)、头晕(6.7%vs 20.0%)等]发生率也低于B组.结论 改良肋间神经冷冻技术能有效促进传统开胸手术后恢复.
目的 探討改良肋間神經冷凍技術在促進傳統開胸手術後恢複中的應用價值及優勢.方法 將100例擇期傳統切口開胸的病人隨機分為A組和B組;A組為改良肋間神經冷凍組(n=50),使用北京K001AND公司JT-Ⅰ型冷凍治療儀在關胸前對切口所在肋間及上、下各一箇肋間和留置胸腔引流管所在肋間的肋間神經進行冷凍;B組為連續硬膜外自控鎮痛組(n=50),採用日本wells公司的電子泵,用嗎啡加氟哌利多行連續硬膜外自控鎮痛(patient control epidural analgesia,PCEA).二組病人均採用視覺模擬評分法(visual analogue scale,VAS)評定術後疼痛程度,觀察二組病人手術後2h、4h、12h、24 h、48h時的VAS的評分,噁心、嘔吐、呼吸抑製,搔癢、腸痳痺等髮生率.結果 A組手術後止痛效果好于B組,手術後鎮痛副反應[如噁心(10.3%vs 23.3%)、嘔吐(10.0%vs 26.7%)、頭暈(6.7%vs 20.0%)等]髮生率也低于B組.結論 改良肋間神經冷凍技術能有效促進傳統開胸手術後恢複.
목적 탐토개량륵간신경냉동기술재촉진전통개흉수술후회복중적응용개치급우세.방법 장100례택기전통절구개흉적병인수궤분위A조화B조;A조위개량륵간신경냉동조(n=50),사용북경K001AND공사JT-Ⅰ형냉동치료의재관흉전대절구소재륵간급상、하각일개륵간화류치흉강인류관소재륵간적륵간신경진행냉동;B조위련속경막외자공진통조(n=50),채용일본wells공사적전자빙,용마배가불고리다행련속경막외자공진통(patient control epidural analgesia,PCEA).이조병인균채용시각모의평분법(visual analogue scale,VAS)평정술후동통정도,관찰이조병인수술후2h、4h、12h、24 h、48h시적VAS적평분,악심、구토、호흡억제,소양、장마비등발생솔.결과 A조수술후지통효과호우B조,수술후진통부반응[여악심(10.3%vs 23.3%)、구토(10.0%vs 26.7%)、두훈(6.7%vs 20.0%)등]발생솔야저우B조.결론 개량륵간신경냉동기술능유효촉진전통개흉수술후회복.
Objective To explore the application value and advantages of modified intercostal nerve freezing technique on postoperative recovery of traditional thoracotomy. Methods 100 patients undergoing conventional thoracotomy incision patients were randomly divided into 2 groups, group A as the modified intercostal nerve freezing group (n = 50) using the Beijing K001AND company JT-Ⅰ treatment only in the off-type freezer chest incision locating on intercostal and upper and lower intercostal space and the indwelling chest tube where the intercostal nerves were frozen;group B, continuous epidural analgesia group (n=50), using the Japanese company's electronic pump wells, plus droperidol with morphine-line continuous epidural analgesia (Patient control epidural analgesia, PCEA). All patients in two groups were using a visual analogue scale (Visual analogue scale, VAS) assessment of postoperative pain,observing patients 2 hours, 4 hours, 12 hours, 24 hours and 48 hours after surgery when the VAS score, nausea,vomiting, respiratory depression, itching, the incidence of intestinal paralysis. Results The post-operative pain of group A was better than that of group B, and the incidence rate of side effect was also lower than that of group B.Conclusions It suggested that the modified intercostal nerve freezing technique could effectively promote postoperative recovery after thoracotomy.
