|
| 硬膜外镇痛对开腹胰腺肿瘤手术患者术后恢复的影响 |
| Impact of patient controlled epidural analgesia on postoperative recovery in patients undergoing laparotomy pancreatic surgeries |
| |
| DOI： |
| 中文关键词: 硬膜外镇痛 加速康复外科 胰腺手术 |
| 英文关键词: Patient controlled epidural analgesia Enhanced recovery after surgery Pancreatic surgeries |
| 基金项目: |
|
| 摘要点击次数: 3004 |
| 全文下载次数: 1904 |
| 中文摘要: |
| 目的 比较开腹胰腺肿瘤手术的加速康复外科(enhanced recovery after surgery，ERAS)流程中硬膜外镇痛和静脉镇痛对患者术后恢复的影响。方法 选择择期行开放胰腺肿瘤手术的患者40例，男27例，女13例，年龄18～70岁，ASA Ⅰ或Ⅱ级，随机分为两组，每组20例。硬膜外镇痛组(E组)行T8～9或T9～10硬膜外间隙穿刺置管，试验剂量给予2%利多卡因3 ml，在切皮前和关腹时分别给予0.375%罗哌卡因5 ml，E组和静脉镇痛组(V组)均行丙泊酚-七氟醚静-吸复合全麻。气管拔管后，E组行硬膜外自控镇痛，V组行静脉自控镇痛。记录患者术后首次下床活动时间、住院时间、肛门排气时间等，以及恶心呕吐、皮肤瘙痒、低血压等术后并发症的发生情况。结果 E组下床活动时间明显早于V组[(50.4±4.2) h vs (64.2±5.0) h，P<0.01]，术后住院时间明显短于V组[(18.5±8.5) d vs (21.5±6.8) d，P<0.05]。两组术后肛门排气时间[(39.7±4.1) h vs (39.5±8.4) h]差异无统计学意义。两组术后并发症发生率差异无统计学意义。结论 在开腹胰腺肿瘤手术的加速康复外科流程中，硬膜外镇痛可产生更好的术后镇痛效果，患者可更早地下床活动，缩短住院时间，且不增加相关并发症。 |
| 英文摘要: |
| Objective To compare the impact of patient controlled epidural analgesia with patient controlled intravenous analgesia on postoperative recovery and complications in patients undergoing laparotomy pancreatic surgeries. Methods Forty patients undergoing pancreatic surgeries, 27 males and 13 females, aged 18-70 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups (n=20 each). Patients in group E received T8-9 or T9-10 epidural block, 2% lidocaine test dose was given to ensure the location of epidural catheter, after that, each patient in group E was given 0.375% ropivacaine 5 ml into epidural space before skin incising and incision closures. Meanwhile, patients in groups E and V received propofol-sevoflurane combined intravenous inhalation anesthesia. After surgery, patients in group E received patient controlled epidural analgesia while patients in group V received patient controlled vein analgesia. Length of hospital stay, time to ambulation and exhaust defecation were recorded. Other complications were compared. Results Compared to group V, patients in group E showed earlier ambulation [(50.4±4.2) h vs (64.2±5.0) h, P<0.01], shorter hospital stays [(18.5±8.5) d vs (21.5±6.8) d, P<0.05]. There was no statistically significant difference in flatus time between the two groups [(39.7±4.1) h vs (39.5±8.4) h]. There was no significant difference in complications between the two groups. Conclusion The present study shows that for patients undergoing pancreatic surgeries, patient controlled epidural analgesia could effectively release post-operative pain, shorten the ambulation time and length of hospital stay with no extra complications. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
