剖胸术后胸痛综合征的临床探讨

目的:探讨剖胸术后胸痛综合征的成因及防治措施。方法:回顾分析我院1996~2005年有随访资料的260例患者,其中患胸痛综合征者42例。探讨术前原发病、手术入路、围术期并发症与胸痛综合征的关系,使用χ2检验;并总结其治疗方法。结果:经肋床入胸者胸痛综合征的发生率为21.38%,经肋间入胸者为7.92%,P<0.05;原发病为肺癌、食管癌、良性病变者,术后胸痛综合征发生率分别为13.92%、20.00%、16.18%,P>0.05;合并术中肋骨骨折、术后切口感染、胸腔积液,胸痛综合征的发生率分别为23.81%、20.00%、17.78%,P>0.05。结论:胸痛综合征与手术入路有明显关系,与术前原发病和围术期并发症无关;多种局部治疗方法联用效果优于单一治疗方法。

The Clinical Discuss of Post-thoracotomy Pain Syndromes

Objective:To explore the cause and treatment of post-thoracotomy pain syndromes.Method :260 cases with follow-up were analyzed retrospectively,to explore connections between post-thoracotomy pain syndromes and preoperative disease,operative entry,post-operative complications.Result: The incidence rate of post-thoracotomy pain syndromes in patients versus resecting rib entry thoracic cavity is 21.38%,in patients versus intercostal space entry thoracic cavity is 7.92%,P<0.05;in patients with lung cancer,esophageal carcinoma and benign disease is 13.92%,20.00%,and 16.18% respectively,P>0.05;in patients with intra-operative rib fracture,post-operative incision infection and pleural effusion is 23.81%,20.00% and 17.78% respectively,P>0.05.Conclusion:Post-thoracotomy pain syndromes has obvious connection with operative entry and no connection with preoperative disease and post-operative complications;the effect of combined treatment are superior to single treatment.