胸部手术后吗啡不同途径术后镇痛的临床研究

目的评价吗啡不同使用方法对胸部手术术后镇痛的临床效果，并探讨其临床意义。方法选择117例开胸手术患者分成硬膜外吗啡镇痛组和肌内注射吗啡镇痛组，比较两组患者心、肺功能指标及术后并发症。结果两组术后血压心率较术前均增高，肺功能较术前均降低，但肌内注射吗啡镇痛组术后24h收缩压、舒张压明显高于硬膜外吗啡镇痛组（P〈0．05），两组术后24h之间心率无显著差异（P〉0．05），肌内注射吗啡镇痛组肺功能术后24h明显低于硬膜外吗啡镇痛组（P〈0．05），肌内注射吗啡镇痛组并发症总发生率明显高于硬膜外吗啡镇痛组（P〈0．05）。结论硬膜外吗啡持续泵入方法用于胸部手术术后镇痛的安全、有效，各项术后指标更接近生理水平，并发症明显少于吗啡肌内注射。

Thoracic surgery after a clinical study of postoperative analgesia

Objective To evaluate the use of different methods of chest surgery after analgesic effect of, and to explore its clincal significance.Methods 117 cases of thoracic surgery patients were divided into epidural morphine analgesic and intramuscular injection of morphine analgesic,compared two groups of patients with heart and lung function indicators and do statistical analysis of postoperative complications.Results After two preoperative BP and HR than the increase in lung function than the former are lower,but intramuscular injection of morphine analgesic group after the SBP、DBP was significantly higher than that of epidural morphine anafgesia group(P＜0.05)between the two groups of heart rate was not significantly different(P＞0.05),intramuscular injection of morphine analgesic group of lung function was significantly lower than that of epidural morphine analgesia group,(P＜0.05)intramuscular injection of morphine analgesic group complication rate was significantly higher than that of epidural morphine analgesia group(P＜0.05).Conclusion Epidural morphine pump continued into the methods used in chest surgery after the effective analgesic,security,after various physiological indicators clearly better than intramuscular injection of morphine.