不同镇痛方式对胸外科患者术后镇痛效果及舒适度的影响

目的探讨静脉自控镇痛（PCIA）和硬膜外自控镇痛（PCEA）对胸外科患者术后镇痛效果及舒适度的影响。方法70例胸外科手术患者按随机数字表法分为Ⅰ组和E组，每组35例。比较两组镇痛、镇静、不良反应及舒适度。结果E组术后各时点VAS评分均低于Ⅰ组，但差异无统计学意义（P〉0．05）；E组镇静满意率94．29％（33／35）]显著高于Ⅰ组65．71％（23／35）]（P〈0．05），不良反应发生率8．57％（3／35）]显著低于Ⅰ组34．29％（12／35）]（P〈0．05）；E组术后24、48、72h的舒适度评分均明显高于Ⅰ组（P〈0．05），其中生理和心理领域差异有统计学意义（P〈0．05），而社会和环境差异无统计学意义（P〉0．05）。结论PCIA和PCEA均能有效镇痛，但PCEA镇静效果好，不良反应少，能从生理和心理上获得更高的舒适度，尤其适用于老年患者。

Influence on postoperative analgesia and comfort level in thoracic surgery patients by different analgesia methods

Objective To investigate the influence on postoperative analgesia and comfort level in thoracic surgery patients by different analgesia methods of PCIA and PCEA.Methods 70 cases of thoracic surgery patients by random number table were divided into group I and group E with 35 cases in each group.The analgesia effects,sedation,adverse reactions and comfort level of two groups were compared.Results The VAS scores of group E were lower than group I at each time point,but the difference was not statistically significant(P > 0.05);the sedation rate of group E was 94.29%(33/35)],which was significantly higher than that of group I 65.71%(23/35)](P < 0.05),the incidence of adverse reactions of group E 8.57%(3/35)] was significantly lower than that of group I 34.29%(12/35)](P < 0.05);the comfort level scores of group E at 24,48,72 h after surgery were significantly higher than that of group I(P < 0.05),there were significant differences in physical and psychological areas(P < 0.05),while the society and the environment had no significant difference(P > 0.05).Conclusion The PCIA and PCEA all have effective analgesia,but the PCEA has better sedative effect and less adverse reactions,which can get greater comfort from the physical and psychological area,and especially suitable for elderly patients.