CAJ | 학술논문

目的：比较开胸术后胸椎椎旁阻滞( thoracic paravertebral block, TPVB)与静脉自控镇痛( patient-controlled intravenous analgesia, PCIA)对患者生活质量的影响,以探索减少术后慢性疼痛( chron-ic post-surgical pain,CPSP)的措施。方法回顾性分析2011年1月至2013年12月行单侧开胸手术的患者192例,根据手术镇痛方法分为TPVB组(97例)与PCIA组(95例)。随访术后CPSP的发生率,并应用简明健康调查问卷(SF-36),分析CPSP患者的生活质量。结果 TPVB组CPSP的患者较PCIA组显著减少,患者总体满意率较优(P<0.05),但生活质量无显著性差异(P>0.05)。结论术中单次TPVB联合术后PCIA镇痛可能是改善开胸手术患者生活质量更合理的方法。
목적：비교개흉술후흉추추방조체( thoracic paravertebral block, TPVB)여정맥자공진통( patient-controlled intravenous analgesia, PCIA)대환자생활질량적영향,이탐색감소술후만성동통( chron-ic post-surgical pain,CPSP)적조시。방법회고성분석2011년1월지2013년12월행단측개흉수술적환자192례,근거수술진통방법분위TPVB조(97례)여PCIA조(95례)。수방술후CPSP적발생솔,병응용간명건강조사문권(SF-36),분석CPSP환자적생활질량。결과 TPVB조CPSP적환자교PCIA조현저감소,환자총체만의솔교우(P<0.05),단생활질량무현저성차이(P>0.05)。결론술중단차TPVB연합술후PCIA진통가능시개선개흉수술환자생활질량경합리적방법。
Objective To evaluate the efficacy of thoracic paravertebral block ( TPVB) and patient-con-trolled intravenous analgesia ( PCIA) on health-associated quality of life and psychological status for patients af-ter thoractomy, and to explore the measure for reducing morbidity of chronic post-surgical pain ( CPSP) . Meth-ods A retrospecitve analysis was performed on 192 patients who underwent thoractomy from January 2011 to December 2013, and they were enrolled as TPVB and PCIA group respectively. Besides, they were followed up for more than 1 year to explore the morbidity of CPSP, furthermore, they completed the self-report questionnaire of 36-item Short Form Health Survey (SF-36) for evaluation of life quality. Results The ratio of CPSP patients in TPVB group was significantly lower than that of PCIA group (P<0. 05). However, there were no significant difference with regard to scores of SF-36 between the groups(P>0. 05). In addition, the overall satisfaction rate of patents in TPVB group is better than that of PCIA group. Conclusions The combination of both TPVB and postoperative PCIA is a more reasonable analgesic procedure to improve the quality of life for patients who underwent thoractomy.