多模式镇痛法治疗PTPS的临床观察

Clinical Observation of Multimodal Analgesia for Treatment of PTPS

目的观察肋间神经阻滞联合芬太尼透皮贴对开胸手术后慢性疼痛综合征的疗效及不良反应.方法应用肋间神经阻滞联合芬太尼透皮贴治疗开胸术后慢性疼痛综合征患者140例,按数字分级法(NRS)判断疼痛缓解程度,采用生活质量评分标准(QOL)评定生活质量变化及观察不良反应.结果总缓解率为97.85%,其中完全缓解51例(36.43%),明显缓解80例(57.14%),中度缓解6例(42.85%).不良反应有恶心、呕吐、便秘、头晕、皮肤瘙痒、排尿困难,没有发生严重肝肾功能损害及呼吸抑制.所有患者的生活质量均有提高.结论多模式镇痛在治疗PTPS中取得较好疗效,不良反应轻,值得在临床推广.

Objective To observe the curative effect and adverse reactions of intercostals nerve block combined with fentanyl transdermal system in treatment of post-thoracotomy pain syndrome （PTPS）. Methods Intercostals nerve block combined with fentanyl transdermal system was used for treatment of 141 patients with PIPS. The degree of pain relief was evaluated by numerical rating scale （NRS）, the quality of life of patients was evaluated by the quality of life score standard, and the adverse reactions were also observed. Results The overall remission rate was 97.85%, there were 51 cases （36.43%） with complete remission, 80 cases （57.14%） with significant remission, and 6 cases （42.85%） with moderate remission. The adverse reactions included nausea, vomiting, constipation, dizziness, skin pruritus and dysuria, no serious liver and kidney function damage and respiratory inhibition. The quality of life of all patients was improved. Conclusion Multimodal analgesia has better curative effect and less adverse reactions in treatment of PTPS, so it deserves clinical promotion