改良肋间神经冷冻及硬膜外自控镇痛在肺癌根治手术后镇痛比较.doc

改良肋间神经冷冻及硬膜外自控镇痛在肺癌根治手术后镇痛比较【摘 要】 目的: 比较改良肋间神经冷冻和硬膜外自控镇痛在肺癌根治手术后镇痛的效果和副作用。方法:60例择期后外侧切口开胸的肺癌根治术病人,随机分为两组,A组为改良肋间神经冷冻组(n=30),使用北京K001AND公司JT-I型冷冻治疗仅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=30),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)。两组病人均采用视觉模拟评分法(usual analogue scale,VAS)评定术后疼痛程度,观察两组病人手术后2h、4h、12h、24h、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,手术后镇痛副反应少于B组,肺癌根治术后镇痛,改良肋间神经冷冻优于PCEA 【关键词】 肋间神经冷冻 硬膜外 术后镇痛 开胸术 肺癌 Comparison between intercostal nerve freezing and epidural analgesia after radical surgery of lung cancer Chen Jishang 【Abstract】 Objective:To compare the improvement of intercostal nerve freezing and epidural analgesia after radical surgery for lung cancer analgesic effects and side effects.Methods:60 cases of elective posterolateral thoracotomy incision radical operation of lung cancer patients were randomly divided into two groups, A group for the improvement of intercostal nerve freezing group (n=30), the use of Beijing K001AND’s JT-I type cryotherapy only in the the intercostal incision is located right off his chest and upper and lower, and retention of an intercostal chest tube drainage of the intercostal nerves intercostal where frozen; B group, continuous epidural analgesia group (n=30), using Japanese wells the company’s electronic pump, With morphine plus droperidol-line continuous epidural analgesia (patient control epidural analgesia, PCEA). Two groups of patients are using visual analog scale (usual analogue scale, VAS) assessment of postoperative pain were observed after surgery the patient 2h, 4h, 12h, 24h, 48h, when the VAS scores, nausea, vomiting, respiratory depression , itching, such as incidence of intestinal paralysis.Results:A group of post-operative pain was better than group B, post-operative pain side effects is less than B group, lung cancer and radical postoperative analgesia, improvement intercostal nerve freezing is better than PCEA. 【Key words】 Intercost