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乳腺癌术后镇痛三种注药模式的临床比较

Clinical Comparison of Three Modes of Postoperative Epidural Analgesia in Breast Cancer Patients

  • 摘要: 目的 比较不同注药模式用于乳腺癌术后硬膜外镇痛的效果、用药量与不良反应。方法 60例择期乳腺癌根治术患者随机分为三组(n=20)术后镇痛。三组镇痛药物配方相同。Ⅰ组采用单纯PCA模式;Ⅱ组采用持续恒量注药(CC)模式;Ⅲ组采用短时间持续恒量注药加病人自控注药(CC+PCA)模式。以视觉模拟评分(VAS)法评估镇痛效果,同时行24小时Bp、HR及SpO2连续监测并计算24小时用药量与恶心呕吐发生率。结果 Ⅰ、Ⅱ、Ⅲ组用药量分别为31.65±12.04ml、48ml、34.60±11.25ml,Ⅰ、Ⅲ组用药量较Ⅱ组明显减少(P<0.01)。Ⅰ、Ⅲ组镇痛效果明显优于Ⅱ组(P<0.05)。三组Bp、HR及SpO2均在正常范围,术后恶心呕吐发生率无显著性差异。结论 乳腺癌术后硬膜外镇痛以短时间CC+PCA注药模式为佳,该模式既能照顾个体差异又能减少患者术后早期因频繁按纽对休息的影响。

     

    Abstract: Objective To compare the effects,drug dosage and side effects of three modes of postoperative epidural analgesia in breast cancer patients,so as to choose the better one. Methods 60 postoperative breast cancer patients were randomly divided into three groups (n=20).The ingredients of the drug in three groups are same.Group Ⅰ were infused with the patient-control analgesia mode (PCA),Group Ⅱ used with coninuous,constant mode (CC),Group Ⅲ used continuous,constant mode short-time,together with PCA(CC+PCA).The patient's Bp、HR and SpO2.were monitored constantly and the 24-hour injection dosage was recorded.The analgesia effect、side effects were under observation. Results (1)The 24-hour drug dosages in Group Ⅰ、Ⅱ、Ⅲ were 31.65±12.04ml、48ml、34.60ml±11.25ml.The Group Ⅰ、Ⅲ were obviously higher than Group Ⅱ(P<0.05).(2)The Group Ⅰ、Ⅲ were superior to Group Ⅱ in 24-hour analgesia effects.(3)During the period of observation,the Bp,HR,and RR were all within normal range.There was no significant difference between the three groups in vomiting occurrences. Conclusion CC+PCA mode is superior to other modes in postoperation epidural analgesia.It not only can meet the needs of individuals,but also let the patients have a good rest without handling the button frequently.

     

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