乳癌术后硬膜外镇痛及其对呼吸功能的影响

The analgesic effect and the influence on respiratory function of PECA after breast cancer surgery

1目的 观察乳癌患者全身、硬膜外联合麻醉术后硬膜外自控镇痛 (PECA)的镇痛效果及对呼吸功能的影响。 2方法 比较PECA组 ( 组 )、单次组 ( 组 )和对照组 ( 组 )硬膜外镇痛患者的镇痛效果 ,监测潮气量 (VT)、肺活量 (VC)、呼吸频率 (RR)和脉搏血氧饱和度 (Sp O2 )的变化。 3结果 组镇痛效果优于 、 组 ,差异显著 (P<0 .0 1) ;VT 组 6h后逐渐上升 ,48h基本恢复正常 ,与 、 组比较 ,差异显著 (P<0 .0 5 ) ;VC术后 3组较术前均下降 ,差异显著 (P<0 .0 1) ,但 组 6h后有逐渐上升趋势 ,而 、 组恢复缓慢 ;RR 组术后 2 4h、48h和 组术后 6h、2 4h、48h明显增快 ,与 组比较 ,差异显著 (P<0 .0 1) ;Sp O2 3组比较无差异 (P>0 .0 5 )。 组术后咳嗽、排痰功能不受影响。 4结论 PECA对乳房癌根治术有良好的术后镇痛作用 ,亦有利于呼吸功能尽早恢复。

Objective To observe the effects and the influence on respiratory function of PECA after breast cancer surgery under general epidural combination anesthesia.Methods To compare the analgesic effect of different groups,ventilation function including tidal volume(VT),vital capacity (VC),respiratory rate(RR) and pulse oxygen saturation(SpO 2) were monitored.Results The analgesic effect of PECA group is better than the other two groups (P<0.01).The VT of group PECA gradually increased after 6h and recover to the normal level at 48h.It has significant difference from the other two groups(P<0.05).The VC of all groups has decreased after operation,but group PECA tends to gradually increase after 6h and the other two seems to recover slowly.The RR become more quickly at 6h、24h、48h after operation except group PECA.The cough reflex keeps well at group PECA.Conclusion PECA after breast cancer surgery has good analgesic effect on the patients and it is better for the recovery of respiratory function as quick as possible. [