静脉自控镇痛泵在子宫肌瘤栓塞治疗中的应用

目的 总结在子宫动脉栓塞治疗子宫肌瘤时,使用静脉自控镇痛泵对预防术中及术后疼痛及介入相关指标临床疗效和经验.方法 109例子宫肌瘤行双侧子宫动脉栓塞的病例,采用碘油平阳霉素乳剂加明胶海绵颗粒为栓塞材料,其中80例使用静脉自控镇痛泵,另29例使用利多卡因100 mg（2 ml）加生理盐水4.0 ml稀释成6.0 ml,患者疼痛不适时由导管注入,必要时加肌肉注射度冷丁50 mg.记录栓塞治疗中及治疗后患者急性缺血反应和症状.结果 与未使用静脉自控镇痛泵的病例相比,使用静脉自控镇痛泵患者术中及术后疼痛症状明显减轻,镇痛效果达85 %（68/80例）,与常规镇痛存在显著差异性.结论 子宫动脉栓塞治疗子宫肌瘤时使用静脉自控镇痛泵可以显著减轻常规栓塞治疗时的疼痛症状,是一种操作简单,效果好的方法,可推进子宫肌瘤动脉栓塞术的广泛应用.

Use of patient-controlled venous analgesia pump in uterine artery embolization treatment of fibroids

Objective To report our experience of using patient-controlled venous analgesia pump during and after uterine artery emholization treatment of fibroids. Methods 109 cases of uterine leiomyomas were treated with bilateral uterine artery embolization using iodinated Pingyangmyein hydrochloride oil emulsion and gelatin sponge granules. Patient-controlled ve- nous analgesia pump was used in 80 patients whereas the remaining 29 patients received intra-catheter injection of Lidocaine 100 mg （2 mL） diluted to 6 mL using 4 mL of saline, and when necessary, intramuscular injection of 50 mg of pethidine. Any acute ischemic symptoms during or after the embolization treatment were recorded. Results The analgesic effect using patient-controlled venous analgesia pump was 85% （68/80） and significantly higher than that of control group with conventional analgesia. Conclusion Patient-controlled venous analgesia pump is simple, less painful and effective method of administering analgesia in uterine artery embolization offibroids.