患者自控镇痛在动脉栓塞治疗子宫肌瘤围手术期中的应用

Applicable study of patient-controlled epidural analgesia in curing uterine myomata for uterine arterial embolization.

目的 :研究患者硬膜外自控镇痛 (PCEA)在子宫动脉栓塞 (UAE)治疗子宫肌瘤中控制疼痛的有效性和安全性。方法 :将 60例 (ASAⅠ～Ⅱ级 )自愿行UAE治疗子宫肌瘤患者随机分成 2组 :A组 (n =30 )采用PCEA法 ;B组 (n =30 )用传统的口服药物 (微粒化尼美舒利 )和 (或 )肌注四氢巴马汀或盐酸哌替定方法。结果 :用PCEA法的患者镇痛质量分数明显优于传统用药法 ,术后恢复快于后者 (P <0 .0 1) ;不良反应 (恶心、呕吐 )发生率相似 ,两组均无呼吸抑制、低血压和心动过缓。结论 :UAE围手术期应用PCEA镇痛效果好 ,副反应少 ,术后恢复快 。

Objective:To study the effectiveness and safety of epidural patient-controlled analgesia (PCEA) for post-operative pain relief after uterine arterial embolization(UAE).Methods:60 patients(ASA Ⅰ～Ⅱ grade)undergoing transcatheter uterine myomata,were randomly divided into two groups:the PCEA group(Group A, n=30)and the controlled group(Group B,n=30),who was either performed traditional oral drugs of micronized nimesulide,or intramuscular injection(plus analgesic of rotundin or pethidine hydrochloride),or both.Results:The quality of pain relief in the PCEA group was obviously superior to that of the controlled group.The PCEA group recovered faster than that of the controlled group after operation(P<0.01).The incidence of side effects (nausea,vomiting)was pretty close.No respiratory depression,hypotension and bradyarrhythmia were observed in both groups. Conclusions:During or after UEA,PCEA could effectively relieve pain by providing less side effects,faster recovery to the patient,and high safety.