不同镇痛方式对食管癌手术后护理的影响

目的：比较硬膜外自控镇痛（PCEA）和静脉自控镇痛（PCIA）对缓解胸部手术患者术后疼痛的影响.方法：将86例食管癌手术患者随机分为E组（n=43）和I组（n=43）,分别使用PCEA和PCIA镇痛,观察2组镇痛效果.结果：术后5 d内视觉模拟评分、使用辅助药物治疗镇痛的用量、术后拔管时间、ICU住院时间、术后开始走路时间和住院时间,2组差异均有统计学意义（P〈0.01）.E组发生肺部并发症3例,I组14例;E组发生吻合口漏2例,I组6例;E组术后发生谵妄2例,I组6例,差异均无统计学意义（P〉0.05）.结论：食管癌患者开胸手术术后PCEA优于PCIA,对改善食管癌手术后护理、减少住院时间和促进患者康复有着积极的意义.

The influence of different analgesic methods on postoperative care of esophageal cancer

Objectlve：To compare the influence of patient-controlled epidural analgesia （PCEA） and patient-controlled intravenous analgesia（PCIA） on relieving the postoperative pain of patient with thoracic operation. Methods：Eighty-six patients with esophageal surgery were randomly divided into PCEA group（ E group ,43 cases） and PCIA group （I group ,43 cases）, and treated with PCEA and PCIA analgesia, respectively. Their effects were observed. Results： The differences of the visual analogue scale at 5 d after operation, the dosage of analgesic auxiliary drug, the hospital stays in ICU, the time of postoperative walking and hospital stays between two groups had statistical significance（P 〈0.01 ）. The occurrence of postoperative pulmonary complications, stomal leak and delirium in group E and group I were 3 cases ＆ 14 cases,2 cases ＆ 6 cases and 2 ＆ 6 cases,respectively,the differences of which had no statistical significance （P 〉 0.05 ）. Conclusions ： The effects of PCEA on relieving the postoperative pain of patients with thoracic operation are better than that of PCIA. The PCEA can improve the postoperative care of esophageal cancer, reduce hospital stays and promote the patients rehabilitation.