【摘要】 目的 比较肋间神经阻滞镇痛和静脉自控镇痛泵的镇痛效果及不良反应。方法 2022年8月至2023年1月四川大学华西医院肺癌中心连续收治并行胸腔镜手术的肺癌患者180例，用随机数字表法将患者分为肋间神经阻滞组（ICNB）及静脉自控镇痛泵组（PCIA）各90例。分析两组患者术后的疼痛程度（VAS）、部位、性质和恶心、呕吐及头晕等。结果 两组患者术后最常见疼痛部位均是手术切口，疼痛性质均是胀痛。术后12及24 h静息状态下疼痛程度评分ICNB组（1.10±0.91,3.12±1.29）均显著低于PCIA组（1.44±0.86,4.32±1.30,P=0.010,P<0.001）。ICNB组恶心、呕吐及头晕发生率（5.56%,23.33%）均显著低于PCIA组（35.56%,51.11%,P<0.001,P<0.001）。ICNB组住院总费用（41 043.16±10 885.63元）显著低于PCIA组（45 283.99±11 036.36元，P=0.010）。结论 肺癌患者微创术后肋间神经阻滞镇痛效果优于静脉自控镇痛泵模式，且不良反应发生率低。更多还原

【Abstract】 Objective To compare the analgesic effects and adverse reactions between intercostal nerve block(ICNB) and patient controlled intravenous analgesia(PCIA). Methods From August 2022 to January2023, 180 patients with lung cancer who underwent thoracoscopic surgery were randomly divided into two groups: ICNB group(n=90) and PCIA group(n=90). The postoperative pain degree(VAS), location,nature; adverse events, such as nausea, vomiting, and dizziness; and other clinical symptoms were analyzed.Results The most common site of postoperative pain in both groups was surgical incision, and the nature of pain was distending pain. At 12 and 24 h after the operation, the pain degree in the ICNB group(1.10±0.91, 3.12±1.29) was markedly lower than that in PCIA group(1.44±0.86, 4.32±1.30, P=0.010, P<0.001). The incidence of nausea, vomiting, and dizziness in the ICNB group(5.56%, 23.33%) was noticeably lower than that in the PCIA group(35.56%, 51.11%, P<0.001, P<0.001). Total hospitalization expense in the ICNB group(41 043.16±10 885.63yuan) was significantly lower than that in PCIA group(45 283.99±11 036.36 yuan,P=0.010). Conclusion The analgesic effect of intercostal nerve block is better than that of patientcontrolled intravenous analgesia pump in patients with lung cancer after minimally invasive surgery, and the incidence of adverse reactions is low.更多还原