摘要
目的探讨改良肋间神经保护技术在食管癌手术中的应用效果。方法选择2012年1月至2014年7月施行开胸手术的食管癌、贲门癌患者70例，随机分成观察组和对照组，每组35例；观察组采用改良肋间神经保护技术进行手术操作；对照组采用传统的操作方法进行手术。两组均采用肌肉注射吗啡药物镇痛。结果观察组术后24h、48h、72h、7d、30d、60d各时点VAS评分与对照组比较，差异均有统计学意义（t值分别为3．041、2．854、1．827、2．156、1．965、2．706，P均〈0．05）；观察组的镇痛不良反应发生率、术后30d及60d无痛患者发生率、吗啡用药剂量、胸管留置时间及平均住院时间分别为0、42．86％、68．57％、（10．6±5．2）mg、（4．0±1．6）d、（17．6±4．5）d，与对照组的17．14％、20．0％、34．29％、（22．8±7．6）mg、（4．8±1．8）d、（20．4±5．8）d相比，差异均有统计学意义（x2值分别为4．56、4．24、8．24，t值分别为7．838、1．965、2．257，P均〈0．05）。结论在食管癌手术中采取改良肋间神经保护技术，既能减轻开胸术后急性疼痛，又能减少慢性疼痛的发生，而且镇痛效果良好，操作简单，不良反应少。
Objective To investigate the clinical effect of protective technique for intercostal nerve in the application of esophageal cancer surgery.Methods Seventy cases of esophageal and cardia cancer patients with thoracic operation were randomly divided into observation group and control group, and each group was 35 cases. Patients in the observation group were treated with improved protective technique of intercostal nerve during operation, and patients in the control group using the traditional methods of operation for treatment. All patients were treated with intramuscular injection of morphine analgesia drugs after operation. Results The pain score of every time point analgesia patients in the observation group （VAS score） was significant difference from that in the control group （ t = 3. 041,2. 854, 1. 827,2. 156, 1. 965,2. 706, P〈0. 05）. The incidence of adverse reactions of analgesia, the incidence of painless patients of postoperative 30 d and 60 d, morphine dosage, chest tube indwelling time and the average hospitalization time in observation group were 0, 42. 86%, 68. 57%, （10.6±5.2） mg （4.0±1.6） d, （17.6±4.5） d , and the control group were 17. 14%, 20.0%, 34.29%, （22.8±7.6） mg, （4.8±1.8） d, （20.4±5.8） d （X2=4.56,4.24,8.24,t=7.838,1.965,2.257,P〈0. 05）. Conclusion The improvement protective technique for intercostal nerve in esophageal cancer surgery, not only can reduce thoracotomy acute postoperative pain, but also reduce the happening of the CPP. Meanwhile, the analgesic effect is good. It is proved with a simple operation , less adverse reaction, conducive to disease recovery after esophageal cancer surgery, indicating that it has clinical popularization value.
出处
《中国综合临床》
2015年第5期429-432,共4页
Clinical Medicine of China
关键词
开胸术
肋间神经保护技术
食管癌
Thoracotomy
Protective technique for intercostal nerve
Esophageal cancer
