肋间神经冷冻止痛的临床应用

Clinical analysis of effect of cryoanalgesia.

目的探索应用冷冻治疗肋间神经痛的疗效和方法。方法将50例需开胸手术的患者随机分成两组,冷冻组与对照组各25例。冷冻组手术结束前冷冻切口、上下各一肋间以及放置引流管之肋间神经根部,根据视觉模拟评分法观察术后切口疼痛以及止痛药使用情况;对照组不用冷冻治疗。结果冷冻组止痛效果极为满意,VAS评分为2.14,而对照组为7.9,差异有非常显著性意义(P<0.01);冷冻组总有效率为92%,吗啡平均用量为2.3mg;而对照组总有效率52%,吗啡平均用量为16.4mg,两组差异有非常显著性意义(P<0.01)。结论冷冻肋间神经能够有效地预防开胸术后剧烈胸痛。

Objective To investigate the effect of Cryonalgesia in post - thoracotomy. Methods A prospective study was earried out in 50 patients undergoing thoraeotomy. Patients were randomized into two groups： control group and eryoanalgesia group. Both were 25 patients. In trial group, eryoanalgesia was applied intraoperatively to the intercostal nerves above and below the incision, and the root of the intercostal nerve of the drainage tube inserted. Except for eryoanalgesia, the treatments of control group are the same as the trail group. Subjective pain relief was assessed on visual analogue scale（VAS）. Results There was significant difference between the trail group and the control group. The VSA score of the trail group and the control was 2.14,and 7.9 （P 〈 0.01）, restectively. In the eryo - group and the control, the total effective rates were 92% and 52% ,resteetively. The mean amount required of morphine in the two groups were 2.3mg and 16.4mg, respteetively （P 〈 0.01）. Conclusion Cryoanalgesia was an efficient method for pain relief after thoraeotomy.