不同镇痛方式对老年患者开胸术后肺功能恢复的影响

目的:研究不同镇痛方式对老年患者开胸术后肺功能恢复的影响。方法:ASA～级老年患者40例随机分为静脉镇痛组及硬膜外镇痛组。检测术前、术后24h、48h、72h时FVC、FEV(1.0)、MMF及PaO2、PaCO2、D(A-a)O2。结果:与术前相比,两组患者术后FVC、FEV(1.0)、MMF及PaO2均下降(P<0.05),而D(A-a)O2均上升(P<0.05),但硬膜外镇痛组优于静脉镇痛组(P<0.05)。结论:连续硬膜外镇痛可明显改善术后肺功能,促进肺内氧合,是一种较好的术后镇痛方法。

The clinical investigation of the effect of different analgesia methods on the recovery of pulmonary function of old patients after operation by open chest approach

Objective: To explore the effect of different analgesia methods on the recovery of pulmonary function of old patients after operation by open chest approach. Methods: 40 old patients with ASA grade 1-2 were randomly divided into intravenous analgesia group and epidural analgesia group.The change of forced vital capacity(FVC), forced expiratory volume in 1 secon(FEV1.0), maximum midexpiratory flow(MMF), alveolar oxygen partial pressure(PaO2), alveolar partial pressure of carbon dioxide(PaCO2) and alveolar arterial oxygen partial pressure gradient(P(A-a)O2) before operation and 24h,48h,72h after operation were recorded respectively. Results: FVC,FEV(1.0),MMF and PaO2 all decreased, while P(A-a)O2 increased compared with pre-operation(P<0.05). And epidural analgesia group were better than intravenous analgesia group. Conclusion: Continuous epidural analgesia could improve pulmonary function after operation and promote oxygenation in lung, so it is a good postoperative analgesia method.