术后镇痛在普通胸外科ICU应用的临床研究

目的：对普通胸外科ICU术后镇痛患者进行临床观察，并通过对各临床指标的监测与比较，认识术后镇痛的临床意义，同时对不同镇痛方法进行对比。方法：在普通胸外科拟行剖胸探查手术的患者中，选择45例并随机均分为3组，即两个试验组（术后分别予以吗啡静脉及硬膜外途径镇痛）和一个对照组（术后予以吗啡肌注镇痛）。对各组患者的术前、术后12h、24h的疼痛视觉模拟评分（VSA评分）、循环功能、血气分析值等分别予以监测和记录，同时还对3组患者的ICU滞留时间和术后并发症进行比较。结果：实验组患者的术后疼痛视觉模拟评分、循环功能、血气分析值、均优于对照组，同时，两试验组本身无显著差异。并发症的统计显示吗啡肌注镇痛组有较多的心律失常、肺部感染、尿潴留等并发症。在ICU滞留时间的比较中无显著差异。结论：该项研究表明硬膜外和静脉途径输注吗啡均能有效的缓解普通胸外科术后疼痛，改善患者的心肺功能，从而改善预后，减少术后并发症的发生。

Clinical research on the postoperative analgesia in intensive care unit of the general thoracic surgery department

Objective;To have a clinical research on the post-operative analgesia of the patients in the intensive care unit of general thoracic surgery department,and understand the clinical significance through the comparison of the clinical values.At the same time,there also have a contrast among the different analgesia methods.Methods;45 patients scheduled thoracotomy were divided randomly into 3 groups;experimental group,including intravenous-morphine analgesia group and epidural-morphine analgesia group,and the control group which received morphine through intramuscularly-injection.In this research,the preoperative and postoperative values were monitored and recorded,such as visual analogue scales (VAS values),circulatory function,artery blood gas analysis,ICU retention stage,the postoperative complication,etc.Results;The values of the experimental group,such as the circulatory function,blood gas analysis,visual analogue scales (VAS values),were better than those of the control group.However,there were no statistical difference between the values of epidural-morphine group and intravenous-morphine group.In the research of the complication,the control group has a higher incidence of the complications,such as the arrhythmia,urine retention,pulmonary infection,etc.At the same time,there were no statistical difference in the ICU retention time of these groups.Conclusion;This research proved that postoperative analgesia,through the way of epidural or venous,may alleviate the post-operation algesia efficiently,better the function of heart and lung,reduce the incidence of the postoperative complication,and achieve the favorable prognosis eventually.