摘要
目的探讨胸外科剖胸手术后肋间神经冷冻镇痛的效果。方法对100例胸外科开胸手术后患者进行随机分为肋间神经冷冻组和对照组各50例患者,按照视觉模拟评分法观察两组患者术后胸部疼痛和镇痛药物的使用情况,术后1、2、3周分别对每组患者行肺功能检查,客观评价肋间神经镇痛治疗在胸外科剖胸术后镇痛的作用。结果冷冻组术后镇痛效果满意,患者视觉模拟评分平均为2.01,对照组为8.13,两组比较有显著差异(P<0.05)。冷冻组患者术后肺功能恢复时间较快,在术后第1周与对照组相比有显著差异(P<0.05),而术后第2周开始至第3周,两组患者肺功能比较无显著差异。结论肋间神经冷冻治疗对剖胸手术后镇痛效果明显,不会对肋间神经造成永久性损害,患者术后肺功能早期恢复,可有效降低肺部并发症,值得临床推广。
Objective To evaluate the effects of cryoanalgesia on pain and respiratory complications in patients undergone thoracotomy. Methods One hundred patients who underwent thoracotomy were prospectively randomized to cryoanalgesia group and control group. Postoperative chest pain was estimated by visual analogue scales （VAS） and pulmonary function on postoperative week 1, 2, 3. The use of rescue pain medication and changes in maximum ventilatory volume and forced expired volume in 1 s were monitored. Results The effective ease pain occurred in cryoanalgesia group. VAS score of the cyoanalgesia and control 8.13, respectively （P 〈0. 01 ）. The marked recovery of pulmonary function first occurred groups was 2. 01 and in cyoanalgesia group on postoperative week 1, with significant difference with that of control group （ P 〈 0. 01 ）. On postoperative weeks 2,3, the pulmonary function in the two groups was of no significance. Conclusion Freezing intercostals nerves during thoracotomy can effectively prevent postoperative chest pain, pulmonary function improves quickly and the pulmonary complications reduce. Cryoanalgesia can be considered as a simple, inexpensive, long-term method for postthoracotomy pain relief, which does not cause any long-term histological damage to intercostal nerves.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2005年第24期2458-2459,共2页
Journal of Third Military Medical University
