病人自控镇痛应用.docVIP

病人自控镇痛在UAE治疗子宫肌瘤围手术期中的应用 雷蔚华1）陈春林1）刘萍1）佘守章2）吕军1）马奔1） (广州市第一人民医院 1）妇产科 妇产医学介入诊疗中心 2）麻醉科, 510180） 【摘要】 目的: 研究病人硬膜外自控镇痛(PCEA)在子宫动脉栓塞(UAE)治疗子宫肌瘤中控制疼痛的有效性和安全性。方法: 选择60例(ASAⅠ～Ⅱ级) 自愿行UAE治疗子宫肌瘤的病人，随机分成两组： A组（n=30），采用PCEA法；B组（n=30），传统的口服药物(微粒化尼美舒利)和/或肌注四氢巴马汀或盐酸哌替定的方法。结果: 采用PCEA法的病人镇痛质量分数明显优于传统用药法,术后恢复快于后者（P＜0.01）；不良反应（恶心、呕吐）发生率相似，两组均无呼吸抑制、低血压和心动过缓。结论: UAE围手术期应用PCEA镇痛效果好，副反应少，术后恢复快，安全性高。 【关键词】 子宫动脉栓塞术；镇痛，硬膜外；病人自控 Applicable study of patient-controlled epidural analgesia in curing uterine myomata for Uterine arterial embolization Lei Weihua, Chen chunlin，Lui Ping,,et al Department of Gynecologic, Guanzhou First Municipal people’s Hospital, Guanzhou, 510180 Abstract Objective To study the effectiveness and safety of Epidural Patient-Controlled Analgesia (PCEA) for post-operative pain relief after Uterine Arterial Embolization(UAE). Methods 60 adult patient (ASA grade ) undergoing transcatheter uterine myomata, were randomly divided into two groups: the PCEA Group (Group A, n=30) and the Controlled Group (Group B, n=30), who was either performed traditional oral drugs of Micronized Nimesulide, or intramuscular injection (plus analgesic of Rotundin or Pethidine Hydrochloride), or both. Results The quality of pain relief in the PCEA Group was obviously superior to that of the Controlled Group. The PCEA Group recovered faster than the Controlled Group did after operation (P0.01). The incidence of aversive side effects (nausea, vomiting) was pretty close. No respiratory depression, hypotension and bradyarrhythmia were observed in both groups. Conclusion During or after UEA, PCEA could effectively relieve pain by providing less side effects，faster recovery to the patient，and high safety. Key words Uterine Arterial embolization; Analgesia Epidural, Patient-controlled 经导管子宫动脉栓塞术(Uterine arterial embolization, UAE)治疗子宫肌瘤已成为近年来介入放射学在妇产科领域中的新应用[1]，因其具有创伤小、治疗效果好的特点而广受欢迎，但UAE术中栓塞时病人有剧烈疼痛感，栓塞后出现的持续数天盆腔继发性痉挛痛，使治疗受到影响，因此如何选择最佳的镇痛方法是更好地应用UAE治疗子宫肌瘤的关键。我院从