摘要
目的探讨在下肢闭合性骨折患者中应用硬膜外自控镇痛(PCEA)进行手术前镇痛的效果。方法将60例患者随机分为观察组和对照组,每组30例,分别予以PCEA和传统止痛方式进行术前镇痛,通过对2组镇痛效果、生理指标、心理状态的比较,以及观察不良反应和硬膜外导管污染的测定,评价PCEA在术前镇痛中应用的优势。结果观察组镇痛效果明显好于对照组,VAS≤3分的百分率(%);静卧时分别为98.3vs78.4,活动时为86.7vs38.6(P均<0.05),生理指标除SpO2外MAP、HR、RR也较对照组更为平稳(P均<0.05),术前焦虑情绪的改善较对照组显著(P均<0.05),未发现不良反应,硬膜外导管细菌培养阴性。结论应用PCEA对下肢闭合性骨折患者进行术前镇痛效果满意,同时能显著减轻患者的焦虑及抑郁情绪,有利于术前准备。
Objective To observe the efficacy of patients＇ controlled epidural analgesic （PCEA） in patients with closed fracture in lower limbs before operation. Methods 60 patients with closed fracture in lower limbs were randomly divided into two groups, observation group and control group（ 30 cases in each group）, PCEA and traditional analgesia were used in the two groups respectively. The advantage of PCEA in pre-operated analgesia was evaluated by comparing analgesic efficacy, patients＇ physical signs and psychological state, and by observing the adverse reaction of analgesia and contamination in epidural conductor for both groups. Results The efficacy of analgesia in observation group was superior to that of control group. The percentage（ % ） of VAS≤3 in the two groups was 98.3 vs 78.4 in static condition,which was 86.7 vs 38.6 in active condition（ P 〈 0.05）. Besides SpO2, MAP, HR,RR in observation group were more stable than those in control group（ P 〈 0.05 ）. The improvement of anxiety feeling before operation in observation group was more obvious than that of control group（ P 〈 0.05）, without adverse reaction and con tamination in epidural conductor. Conclusion The analgesic effect of PCEA is satisfactoly on the pre-operated patients with closed fracture in lower limbs, which can relieve patients＇ anxiety and depression, as a result, which is helpful to the preparation before operation.
出处
《疑难病杂志》
CAS
2008年第2期91-93,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
自控镇痛
硬膜外
骨折
闭合性
术前镇痛
Patients＇ controlled analgesia, epidural
Fracture, closed
Preoperative analgesia
