肋间神经冷冻止痛在预防开胸术后切口疼痛的临床研究

Clinical Study of Freezing Intercostal Nerves in Preventing the Post-thoracotomy Chest Pain

目的 探讨减轻和消除开胸术后切口疼痛的方法。 方法 对100例后外侧开胸手术的病人随机分组,研究组和对照组各50例。研究组病人常规手术后行冷冻切口及切口为上下各一肋间及放置引流管的肋间神经根部,冷冻时间为90秒,根据视觉模拟评分法(VAS)观察术后切口疼痛以及记录使用哌替啶针的用量,术后随访3～6个月。对照组病人除不用冷冻治疗外,其他同研究组。 结果 研究组止痛效果满意,总的有效率(0～6级)为92%,平均VAS评分2.12,使用哌替啶针平均40.0mg/例;对照组总的止痛有效率(0～6级)为24%,平均VAS评分7.54,使用哌替啶针平均205.0mg/例。两组差异有非常显著意义(P<0.01)。术后随诊3～6个月,两组病人切口处感觉无明显差别。 结论 肋间神经冷冻能有效预防开胸术后切口疼痛。

Object To explore the method of alleviating and preventing postoperative chest painafter thoracotomy. Methods A randomized trial was carried out in 100 patients who had indergonethoracotomy and were divided into the study group and the control group with 50 patients in eachgroup. Before closing the chest,4 routes of costal nerves (incision above and below, and one forinserting drainage tube) were frozen for 90 seconds separately. The postoperative incision pain wasrecorded by the VAS (visual analogue scales), including recording the dosage of pethidines. ResultsThe study results have shown analgesia effect and the total effective rate (0～6 degrees) was 92%.The VAS score was 2.12 and the dosage of pethidines was 40.0mg. While in the control group, the totaleffective rate (0～6 degrees) was 24% and the VAS score was 7.54, with a dosage of pethidines for205.0mg, respectively (p<0.01). Conclusion Freezing intercostal nerves during the thoracotomy canprevent the postoperative chest pain effectively.