摘要
目的观察持续胸椎旁神经阻滞用于多发肋骨骨折镇痛的临床效果。方法选择多发肋骨骨折患者92例,按照胸椎旁神经阻滞给予罗哌卡因持续泵入镇痛(TPVB组)和根据疼痛程度间断给予吗啡镇痛(MOP组)两种治疗方案进行回顾分析,每组46例。观察指标:TPVB组置管前后疼痛评分(VAS)和呼吸频率(RR),TPVB组和MOP组在置管后12、24 h动脉血氧分压、二氧化碳分压及伤后5 d胸腔积液量。结果 TPVB组置管后VAS评分明显降低,呼吸频率明显减低(P<0.05),TPVB组12、24 h动脉血氧分压明显高于MOP组,二氧化碳分压明显低于MOP组,差异均有统计学意义(P<0.05),TPVB组伤后5 d胸腔积液量较MOP组明显减少(P<0.05)。结论持续胸椎旁神经阻滞对多发肋骨骨折镇痛效果较好,有效促进肺功能恢复,减少肺不张的形成。
Objective To observe the analgesic effect of continuous thoracic paravertebral block in patients with multiple fractured ribs. Methods A total of 92 patients with unilateral fractured ribs were randomly divided into 2 groups：TPVB group（ n = 46,received continuous ropivacaine infusion through thoracic paravertebral block） and MOP group（ n = 46,received various dosages of morphine）. Visual analog scale scores（ VAS） at rest and on coughing,and respiratory rate were measured before and after administration of the block. The postoperative 12-hour and 24-hour oxygen partial pressure（ PO_2） and partial pressure of carbon dioxide（ PCO_2）,and 5-day post-injury pleural effusion quantity were detected. Results After administration of block,the mean VAS and respiratory rate decreased significantly（ P〈0. 05）. The average PO_2 in the TPVB group were higher than that in the MOP group（ P〈0. 05）,while the average PCO_2 were significantly lower in the TPVB group than that in the MOP group（ P〈0. 05）. The 5-day post-injury pleural effusion quantity of TPVB group was less than that of MOP group（ P〈0. 05）. Conclusion Continuous thoracic paravertebral block significantly improves pulmonary function and relieves pain,and shortens pulmonary atelectasis in patients with multiple fractured ribs.
出处
《山东大学学报（医学版）》
CAS
北大核心
2016年第6期39-42,共4页
Journal of Shandong University:Health Sciences
