改良肋间神经冷冻技术在传统开胸手术后恢复中的应用

目的：探讨改良肋间神经冷冻技术在促进传统开胸手术后恢复中的应用价值及优势,对改良肋间神经冷冻和硬膜外自控镇痛在传统开胸手术后镇痛的效果和副作用进行对比,证实改良肋间神经冷冻技术能有效促进传统开胸手术后恢复。方法：2004年5月~2011年5月阳江市人民医院胸外科进行100例择期传统切口开胸手术的患者,随机分为两组,A组为改良肋间神经冷冻组（n=50）利用杭州K001AND公司JT-1型冷冻治疗,在关胸前对切口所在肋间及上、下各一个肋间神经进行冷冻治疗;B组为连续硬膜外自控镇痛组（n=50）,采用日本wells公司的电子泵,用吗啡加氟哌利多行连续硬膜外自控镇痛（patient control epidural analgesia,PCEA）。两组患者均采用视觉模拟评分法（usual analogue scale,VAS）评定术后疼痛程度,观察两组患者手术后2、4、12、24、48h时的VAS的评分,恶心、呕吐、呼吸抑制、瘙痒、肠麻痹等发生率。结果：A组手术后止痛效果好于B组,手术后镇痛副反应少于B组,传统开胸手术后镇痛,改良肋间神经冷冻优于PCEA。结论：证明改良肋间神经冷冻技术在促进传统开胸手术后恢复中有较大的应用价值及优势。

Application of improved intercostal nerve freezing technology to recovery after conventional thoracotomy

Objective： To investigate the value and advantages of improved intercostal nerve frigeration technology in promotingrecovery after conventional thoracotomy, the effectiveness and side effects of the improved intercostal nerve freezing were compared with those of controlled epidural analgesia after conventional thoracotomy, improved intercostal nerve freezing technique is proved effective in promoting recovery after conventional thoracotomy. Methods： One hundred cases of patients undergoing conventional thoracotomy were randomly divided into two groups, A group for the improvement of the intercostal nerve freezing group （n=50） were treated by the Hangzhou KO01AND company JT-1, their intercostal nerves were frozen, only in incision intercostal and upper and lower intercostal space and an indwelling chest tube; B group, continuous epidural analgesia group （n=50）, using the Japanese company＇s electronic pump wells, plus droperidol with morphine-line continuous epidural analgesia （patient control epidural analgesia, PCEA）. Degree of postoperative pain for two groups of patients was assessed by a visual analogue scale （usual analogue scale, VAS）, the VAS score of two groups of patients and the incidence of nausea, vomiting, respiratory depression, itching, intestinal paralysis in ：2, 4, 12, 24, 48 h after surgery were observed. Results： Analgesic effect of A group was better than B group, analgesic side effects of A group was less than B group, the improvement intercostal nerve freezing surpasses PCEA. Conclusion： It is proved that improved intercostal nerve frigeration technology in promoting recovery after conventional thoracotomy have a greater value and benefits.