自控镇痛对开胸术后病人肺功能及整体康复的影响

The recovery of pulmonary and body function in postthoracic surgery patients with self-analgesia

目的探讨自控镇痛对开胸术后病人肺功能及整体康复的影响。方法选择80例应用自控镇痛开胸术后病人为试验组,与80例同期同类开胸术后传统肌注镇痛患者做对照;检测开胸术后两组病人24～72h的血气指标〔二氧化碳分压(PCO2)、氧分压(PO2)、肺泡-动脉氧分压差(A-DO2)、氧合指数(OI)、呼吸指数(RI)、酸碱度(pH)、血氧饱和度50%时氧分压(P50)〕、肺功能指标{潮气量(VT)、1秒率(FEV1%)、通气储备百分比〔(MVV-VE)/MVV%〕}及整体康复指标。结果开胸病人术后血气指标两组对比:血气指标:PCO2、PO2、A-DO2、OI、RI有显著性差异(P<0.05);pH、P50无显著性差异(P>0.05);肺功能及整体康复指标两组对比均有显著性差异(P<0.05),试验组肺功能恢复快,肺不张的发生率1.25%;试验组较对照组同等抗生素使用时间缩短2.41d,术后血常规白细胞(WBC)≤10.0×109时间缩短1.90d,平均住院日缩短1.88d。结论硬膜外自控镇痛对开胸病人术后副作用小,肺功能恢复快,整体康复好,值得推广。

Objective To discuss the recovery of pulmonary and body function in postthoracic surgery patients with self-administrated analgesia. Methods Eighty postthoracic surgery patients with self-administrated analgesia were test group.Another 80 postthoracic surgery patients with injection-analgesia were as contrast group.Blood gas analysis index(PCO_2、PO_2、A-DO_2、OI、RI、pH、P50 )and pulmonary function (VT,FEV1%,(MVV-VE)/MVV%)and whole recovery index of the patient 24h～72h after surgery were analyzed. Results Pulmonary function index significant differences were found in PCO_2、PO_2、A-DO_2 、OI and RI(P<0.05).The whole recovery and pulmonary function index:significant differences were found in VT,FEV1% and(MVV-VE)/MVV% (P<0.05).Pulmonary function was recovered faster in test group and the pulmonary atelectasis rate was 1.25%.The antibiotics used were reduced 2.41d than the control group.The blood regular test in text section showed WBC≤10.0×109 was 1.90d earlier than those in control group. Conclusion It is suggested that postthoracic surgery patients with self-administrated analgesia especially with epidural-self-analgesia show less side effect and faster recovery.