摘要
目的 探讨患者静脉自控镇痛（PCIA）用于乳腺癌根治术术后疼痛治疗效果及不良反应.方法 选择择期乳腺癌根治术的患者210例,按随机数字表法分为两组：研究组（A组）：术后应用PCIA治疗术后疼痛;对照组（B组）：肌注哌替啶治疗术后疼痛,每组105例.A组以首次量＋持续给药＋自控给药行PCIA 48 h.B组采用哌替啶50 mg肌注,间隔时间须＞6h.术后4、8、12、24、48 h采用VAS评分评估安静状态疼痛程度,监测脉搏、呼吸、血压,观察有无皮肤瘙痒、恶心呕吐和呼吸抑制等不良反应.结果 （1）VAS评分：术后4、8、12、24、48 h各时点A组患者VAS评分分别为（2.02±1.47）分、（1.73±1.38）分、（1.68±0.91）分、（1.44±0.65）分、（1.21±0.61）分,相应时点B组患者VAS评分分别为（6.95±1.96）分、（6.42±1.57）分、（5.63±1.66）分、（4.99±1.62）分、（3.72±1.46）分,各时间A组患者VAS评分均明显低于B组（P＜0.05）.（2）不良反应：A组术后皮肤瘙痒、恶心呕吐、呼吸抑制不良反应发生均明显低于B组（P＜0.05）.（3）镇痛满意度：术后48 h患者镇痛A组总体满意度（96.18％）显著高于B组（67.61％,P＜0.01）.结论 PCIA治疗乳腺癌根治术术后疼痛临床效果优良,降低术后皮肤瘙痒、恶心呕吐、呼吸抑制等不良反应发生率,提高患者的镇痛满意度.
Objective To investigate the analgesic effect and adverse reactions of patient-controlled intravenous analgesia （PCIA） in breast cancer patients with radical mastectomy.Methods A total of 210 breast cancer patients who underwent radical mastectomy was randomly divided into two groups,experimental （group A） and control （group B） groups （n =105 cases per group）.Patients in group A was used PCIA for 48 hours analgesia,while group B weas applied routine intramuscular injections of pethidine.Visual analogue score （VAS） at 4,8,12,24,and 48 hours after operation were recorded.Pulse,respiration,and blood pressure were monitored and side effects e.g.existed skin itching,nausea,vomiting,and respiratory repression were observed.Results The VAS of group A patients on 4,8,12,24,and 48 hours were2.02 ± 1.47,1.73 ± 1.38,1.68 ± 0.91,1.44 ± 0.65,and 1.21 ± 0.61,respectively;and the VAS of group B patients were 6.95 ± 1.96,6.42 ± 1.57,5.63 ± 1.66,4.99 ± 1.62,and 3.72 ± 1.46,respectively.The VAS was significantly lower in group A patients than in group B （P 〈 0.05）.The incidence of skin itching,nausea,vomiting,and respiratory repression was also distinctly decreased in group A than in group B （P 〈0.05）.The overall satisfaction of patients in group A （96.2%） was remarkably higher than in group B （67.6%） （P 〈0.01）.Conclusions Patient-controlled intravenous analgesia pump can more effectively alleviate the degree of pain,reduce the incidence of skin itching,nausea,vomiting and respiratory repression,improve the satisfactory degree for analgesia in breast cancer patients with radical mastectomy compared to traditional intramuscular way.
出处
《中国医师杂志》
CAS
2016年第4期505-507,共3页
Journal of Chinese Physician
基金
中南大学中央高校基本科研业务费专项资金资助项目（2014zzts339）
湖南省自然科学基金资助项目（2015JJ4098）
作者简介
通信作者：李乐之，Email：1126511@sina．com
