高血压性脑出血术后病人静脉自控镇痛效果观察

Feasibiiity of Patient-controlled Infusion Analgesia in Postoperative Hypertensive Brain Hemorrhage

目的探讨高血压性脑出血(HBH)术后病人静脉自控镇痛的效果。方法将60例HBH手术病人随机分为传统镇痛组(CAT组)和静脉自控镇痛组(PCA组),各30例。CAT组采用传统肌内注射镇痛剂镇痛,PCA组采用镇痛泵行静脉自控镇痛,观察并记录不同时间两组病人躁动发生情况,不同时间RR、HR、SBP、DBP、SpO2、Vt值以及两组再出血发生率及VASS评分等情况。结果HBH术后病人不同时间躁动发生率PCA组明显低于CAT组(P<0.05);两组不同时间RR、SBP、DBP、Vt、SpO2比较,差异有显著性意义(均P<0.05);两组镇痛用药情况、再出血发生率及满意度评分比较,差异有显著性意义(均P<0.01)。结论HBH术后病人静脉自控镇痛安全,且能有效预防术后再出血的发生。

Objective To study the feasibility of patient-controlled infusion analgesia (PCA) in preventing recurrence of post-operative hypertensive brain hemorrhage (HBH). Methods Sixty patients with HBH were randomly divided in-to PCA group and conventional analgesia therapy (CAT) group, each groups having 30 patients. 48 hours after the operation, Pethedine, Chlorpromazine and Promethazine were given, according to irritability and severity of pain of the patients in CAT group, while in PCA group, patient-controlled infusion analgesia was used. The effects were observed 4, 8, 12, 16, 24 and 48 hours after the treatment, and the scores of pain, calmness, RR, SBP, DBP, HR, Vt, SpO2, recurrence of bleeding and patients' satisfaction were recorded. Results The irritable condition in PCA group was significantly lower than that of CAT group (P<0. 05) . Significant differences were found in SBP, DBP, Vt, RR, SpO2 (all P<0. 05) and scores of re-bleeding and vtisfaction (all P<0. 01) between the two groups. Conclusion Patient-controlled infusion analgesia for post-operative hypertensive brain hemorrhage is safe and effi-cient, and can effectively prevent postoperative rebleeding.