【摘要】 目的研究肋间神经冷冻用于开胸手术后止痛的效果。方法228例常规后外侧切口开胸手术患者,随机分为三组,分别应用不同的术后镇痛方法。对照组采用临时肌肉注射曲马多镇痛;患者应用自控静脉镇痛(patient controlled intravenous analgesia,PCIA)组;冷冻组应用-60℃探头进行开胸肋间隙及上下各一肋间神经冷冻90 s。应用视觉模拟评分法(VAS)进行疼痛评估,同时记录镇痛药物使用情况,比较各组术后肺部并发症的发生率及第1秒末用力呼气容积(FEV1)的实测值。结果冷冻组患者的疼痛程度显著弱于PCIA组和对照组(P<0.05),肺部并发症的发生率也显著低于对照组(P<0.05),冷冻组FEV1值较对照组高(P<0.05)。结论肋间神经冷冻可以有效地减轻开胸术后患者的疼痛,并减少肺部并发症的发生。更多还原

【Abstract】 Objective To investigate the effects of cryoanalgesia of the intercostal nerve on post-thoracotomy pain.228 patients suffering from thoracotomy were divided into three groups randomly,according to different analgesia methods respectively.Control group(n=58):Tramadol was given irregularly intra-muscularly.Patient controlled intravenous analgesia(PCIA group,n=80): patient controlled analgesia was done intravenously.Cryoanalgesia group(n=90): three intercostal nerves were frozen at-60 ℃ for 90 seconds.Severity of pain was graded by visual analogue scale.Forced expiratory volume in one second(FEV1)was measured and pulmonary complications after the operation were compared.Results There was a statistically significant improvement in postoperative pain scores and respiratory function test for the patients in cryoanalgesia group(P<0.05).FEV1 in cryoanalgesia group was significantly higher than that in control group(P<0.05).Pulmonary complications in cryoanalgesia group after operation were lower than those in control group(P<0.05).Conclusion Cryoanalgesia for post-thoracotomy pain is effective and may reduce pulmonary complications after the operation.更多还原