硬膜外自控镇痛在下肢骨肿瘤患者术后镇痛中的应用

Application of patient-controlled epidural analgesia in postoperative analgesia of lower limb bone tumor

目的探究硬膜外自控镇痛在下肢骨肿瘤患者术后镇痛中的应用效果。方法将80例下肢骨肿瘤患者根据治疗方法不同分为对照组及观察组,每组40例。对照组采用常规镇痛,观察组采用硬膜外自控镇痛,比较两组患者血清疼痛依存指标、Ramsay镇静评分、术后活动状态下视觉模拟评分法(VAS)评分及不良反应。结果术后12 h,两组患者白细胞介素-6、白细胞介素-1β、肿瘤坏死因子-α水平均升高(P﹤0.05),但观察组各指标均明显低于对照组(P﹤0.01)。术后不同时间两组患者Ramsay镇静评分比较,差异均无统计学意义(P﹥0.0.5)。术后8、12、24、48 h观察组患者VAS评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。两组患者不良反应总发生率比较,差异无统计学意义(P﹥0.05)。结论下肢骨肿瘤术后实施硬膜外自控镇痛可有效改善机体炎性因子水平,缓解术后疼痛,具有良好镇痛效果及较高安全性,临床应用价值较高。

Objective To explore the effect of patient-controlled epidural analgesia in postoperative analgesia of low-er limb bone tumor.Method A total of 80 patients with lower limb bone tumors were divided into control group and ob-servation group,with 40 cases in each group according to different treatment methods.Among them,routine analgesia was used in the control group,and patient-controlled epidural analgesia was conducted in the observation group.Serum pain-dependent indicators,the score of Ramsay sedation scale,visual analog scale(VAS)in postoperative activity status,and adverse events were compared between the two groups.Result Twelves hours after the operation,the levels of inter-leukin6,interleukin-1β,and tumor necrosis factor-αincreased in the two groups(P<0.05),but the indicators in the obser-vation group were significantly lower than those in the control group(P<0.01).There was no statistically significant dif-ference in Ramsay sedation scale scores between the two groups of patients at different times after the surgery(P>0.05).The VAS scores of patients in the observation group were significantly lower than those in the control group at 8,12,24,48 hours after the surgery,and the differences were statistically significant(P<0.01).There was no significant difference in the incidence of adverse events between the two groups of patients(P>0.05).Conclusion Postoperative patient-con-trolled epidural analgesia for lower limb bone tumors can effectively improve the level of inflammatory factors in the body and relieve postoperative pain.This method has a good analgesic effect with high safety whose clinical application value is relatively high.