自控静脉镇痛对肝癌介入术后患者的镇痛临床效果与护理

Clinical application and nursing of patient controlled intravenous analgesia in patients with hepatocellular carcinoma treating by trans-catheter arterial chemoembolization

目的评价自控静脉镇痛在缓解肝癌介入术后患者疼痛中的临床效果。方法选择2013年9月~2015年11月在本科行肝癌介入且术后肝区疼痛的100例患者,按照随机数字表法分为两组,每组50例。对照组采用常规镇痛方式,观察组采用自控静脉镇痛(PCIA)。比较两组患者术后视觉模拟评分(VAS)和不良反应发生率。结果观察组术后6 h、24 h和48 h时间点的VAS评分均低于对照组(P<0.05);两组术后72 h VAS评分比较差异无统计学意义(P>0.05);观察组术后恶心呕吐、便秘发生率明显低于对照组(P<0.01);两组患者发热、尿潴留发生率比较差异无统计学意义(P>0.05)。结论自控静脉镇痛应用于肝癌介入术后患者镇痛,可行有效。

Objective To evaluate the effects of PCIA on alleviating pain of patients with hepatocellular carcinoma by TACE. Methods One hundred patients with hepatocellular carcinoma by TACE from September 2013 to November 2015 were randomly divided imo two groups, 50 cases in each. Patients in control group was treated with conventional analgesia way, while observation group with PCIA. Then the VAS and incidence of adverse reactions were compared. Results VAS of control group were higher than that of observation group at 6h, 24h and 48h, no significant difference between the two groups was found at 72h （ P 〉 0.05 ）. Compared with control group, postoperative nausea, vom- iting, constipation of observation group were significantly lower （P 〈 0.01 ） , no statistically difference in fever and urinary between the two groups was observed（ P 〉 0.05 ）. Conclusions The PCIA can be effective in alleviating pain of patients with hepatocellular carcinoma by TACE. Key words： Patient controlled intravenous analgesia; Postoperative analgesia ; Nursing