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目的观察三种不同的镇痛方式对食管癌根治术后镇痛效果及患者对术后镇痛方式的满意程度,以探讨最佳的镇痛方式。方法选择90例行食管癌根治术患者,随机分成三组:硬膜外自控镇痛组,静脉自控镇痛组,肌肉注射吗啡镇痛组。连续48h观察患者的镇痛效果、满意程度、及术后并发症发生率的情况;检测术后48h内患者的镇痛镇静情况,连续监测患者的脉搏氧饱和度血压心率。结果硬膜外自控镇痛组镇痛效果、满意程度明显优于另外两组,低氧血症的发生率及程度明显低于另外两组。结论食管癌根治术后应用PCEA镇痛较为完善,可明显改善术后肺功能,促进肺内氧合,并发症少,病人满意度高.是一个较好的术后镇痛方法。
Objective To observe the effect of three different analgesic methods on postoperative analgesia of patients with esophageal cancer after radical resection and the patients’ satisfaction with postoperative analgesia to explore the best way of analgesia. Methods Ninety patients undergoing radical resection of esophageal cancer were randomly divided into three groups: controlled epidural analgesia group, controlled intravenous analgesia group and intramuscular morphine analgesia group. The analgesic effect, the degree of satisfaction and the incidence of postoperative complications were observed for 48 hours. The analgesic and sedation of the patients within 48 hours after the operation were monitored, and the pulse pressure and heart rate of the patients were continuously monitored. Results The analgesic effect of epidural analgesia was significantly better than the other two groups. The incidence and extent of hypoxemia were significantly lower than the other two groups. Conclusion The application of PCEA after radical resection of esophageal cancer analgesia is more perfect, can significantly improve postoperative pulmonary function, promote lung oxygenation, fewer complications, patient satisfaction is a better postoperative analgesia.